Abstract | PURPOSE: The aim of this retrospective study was to compare the clinical outcomes of pembrolizumab- lenvatinib-transarterial chemoembolization (TACE) versus lenvatinib-TACE sequential therapy in selected populations of Chinese patients with initially unresectable hepatocellular carcinoma (uHCC) harbouring programmed cell death ligand-1 (PD-L1) expression. METHODS: Consecutive patients with initial PD-L1-positive uHCC who received pembrolizumab- lenvatinib-TACE or lenvatinib-TACE sequential therapy were retrospectively identified from three medical institutions during 2016-2020. The primary endpoints included the rate of conversion therapy, defined as converting initially uHCC to hepatectomy, overall survival (OS), and progression-free survival (PFS); secondary endpoint was the frequency of key adverse events (AEs). RESULTS: In total, 220 consecutively recruited patients were retrospectively reviewed, 78 of whom were ineligible according to the current criteria, leaving 142 patients [ pembrolizumab- lenvatinib-TACE: n = 70, median age 58 years (range 36-69) and lenvatinib-TACE: n = 72, 57 years (35-68)] who were eligible for the study. The median duration of follow-up was 27 months [95% confidence interval (CI), 26.3-28.7 months]. At the last follow-up, the rate of conversion therapy was 25.7% in the pembrolizumab- lenvatinib-TACE group and 11.1% in the lenvatinib-TACE group (p = 0.025). The median OS was 18.1 months (95% CI 16.5-20.7) in the pembrolizumab- lenvatinib-TACE group versus 14.1 months (95% CI 12.2-16.9) in the lenvatinib-TACE group [hazard ratio (HR) 0.56, 95% CI 0.38-0.83; p = 0.004]. A distinct difference in the median PFS interval between the groups was detected [9.2 months (95% CI 7.1-10.4) in the pembrolizumab- lenvatinib-TACE group vs. 5.5 months (95% CI 3.9-6.6) in the lenvatinib-TACE group (HR 0.60; 95% CI 0.39-0.91; p = 0.006)]. The rates of the key AEs assessed, which were hypertension, nausea, and rash, were higher in the pembrolizumab- lenvatinib-TACE group than in the lenvatinib-TACE group (all p < 0.05). CONCLUSION: Among the selected populations of patients with initial PD-L1-positive uHCC, pembrolizumab- lenvatinib-TACE sequential therapy may have promising antitumour activity, with an acceptable conversion rate and a well-characterized safety profile.
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Authors | Song Chen, Zhiqiang Wu, Feng Shi, Qicong Mai, Liguang Wang, Fan Wang, Wenquan Zhuang, Xiaoming Chen, Huanwei Chen, Bo Xu, Jiaming Lai, Wenbo Guo |
Journal | Journal of cancer research and clinical oncology
(J Cancer Res Clin Oncol)
Vol. 148
Issue 8
Pg. 2115-2125
(Aug 2022)
ISSN: 1432-1335 [Electronic] Germany |
PMID | 34453221
(Publication Type: Journal Article)
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Copyright | © 2021. The Author(s). |
Chemical References |
- Antibodies, Monoclonal, Humanized
- B7-H1 Antigen
- Phenylurea Compounds
- Quinolines
- pembrolizumab
- lenvatinib
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Topics |
- Adult
- Aged
- Antibodies, Monoclonal, Humanized
- B7-H1 Antigen
- Carcinoma, Hepatocellular
(drug therapy, pathology)
- Chemoembolization, Therapeutic
- Humans
- Liver Neoplasms
(drug therapy, pathology)
- Middle Aged
- Phenylurea Compounds
- Quinolines
- Retrospective Studies
- Treatment Outcome
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