A real-world study of the efficacy of second-line treatment of unresectable hepatocellular carcinoma with esophagogastric varices after progression on first-line lenvatinib combined with PD-1 inhibitor

World Journal of Surgical Oncology, Journal Year: 2025, Volume and Issue: 23(1)

Published: March 13, 2025

Abstract Purpose The incidence and mortality of hepatocellular carcinoma are still high according to National Cancer Center China. Atezolizumab plus bevacizumab has become one the standard regimens for first-line treatment unresectable carcinoma. However, some patients use lenvatinib in combination with immunotherapy instead a “atezolizumab-bevacizumab” regimen as lower risk bleeding esophagogastric varices. there is no evidence second-line therapy after progression on combined PD-1 inhibitor till now. Herein, we aim investigate among these patients. Patients methods Thirty-three varices were admitted Second Affiliated Hospital Nanchang University from January 2019 December 2023. They treated first line. efficacy was conducted RECIST1.1 criteria. endpoints included objective response rate (ORR), disease control (DCR), median overall survival (OS), free (PFS). Results We identified total 225 who received inhibitor, whom 33 (14.7%) therapy. 21 (63.6%) regorafenib 6 (18.2%) apatinib 4 (12.1%) remaining 2 or sorafenib monotherapy, respectively. Of patients, (6.1%) evaluated partial (PR), 16 (48.5%) had stable (SD), 15 (45.4%) experienced (PD). ORR 6.1%, DCR 54.6%. Median PFS 4.5 months, OS 7.2 12-month 27.3%. Overall follow-up done 37 without second line whose baseline levels matched those group. months group versus 3.0 ( p = 0.04). As different treatments line, 9.5%, 47.6%, 4.2 5.9 months. None got PR, 83.3%, 8.7 9.1 25.0%, 2.2 6.0 Conclusion effective. Regorafenib might be preferred options.

Language: Английский

The efficacy and safety of adding hepatic arterial infusion chemotherapy using cisplatin to lenvatinib for advanced hepatocellular carcinoma

Hepatology Research, Journal Year: 2025, Volume and Issue: unknown

Published: April 9, 2025

Combination therapy with lenvatinib and hepatic arterial infusion chemotherapy (HAIC) using cisplatin had a high antitumor effect for advanced hepatocellular carcinoma (HCC); however, the efficacy of adding HAIC to remains unclear. We retrospectively reviewed charts HCC patients who were treated or plus compared between them. The received 12 mg 8 once daily by weight in both groups, 65 mg/m2 through artery every 4 weeks group. A total 140 included this analysis, 40 each group groups selected propensity score matching analysis. Objective response rate (20.0 vs. 67.5%, p < 0.001), progression-free survival (median 4.6 9.2 months, = 0.032), overall 12.1 20.6 0.024) significantly better those Subgroup analysis suggested greater prognostic benefit larger tumor size, vascular invasion, prior treatment immune checkpoint inhibitors. Although main grade 3-4 adverse events more frequently observed hematological toxicities, all manageable. Adding improved outcome patients. Further studies are needed confirm these results explore clinical positioning HAIC.

Language: Английский