66 - Systematic Review and Meta-Analysis Of Comparing the Efficacy of TACE Plus Lenvatinib with and without PD-1 Inhibitors in Unresectable Hepatocellular Carcinoma

Monday, March 31, 2025

12:10 PM – 1:10 PM CT

Location: Music City Center, Expo Poster Area

Poster Presenter(s)

Leila Haghani, MD, MPH

Postdoc Fellow
UMass Chan Medical School, Interventional Radiology, United States

Author/Co-author(s)

RS

Ramin Shahidi, MD

Postdoc Fellow
Bushehr University of Medical Science, Radiology Department, Iran
MB

Mansoureh Baradaran, MD

Postdoc Fellow
Bushehr University of Medical Science, Radiology Department, Iran
FS

Farzaneh Shojaeshafiei, MD

Postdoc Fellow
Bushehr University of Medical Science, Radiology Department, Iran

Purpose:

Unresectable hepatocellular carcinoma (HCC) remains a significant therapeutic challenge due to limited treatment options and poor prognosis. Transarterial chemoembolization (TACE) combined with lenvatinib has shown promise in improving patient outcomes. Recently, the addition of programmed death-1 (PD-1) inhibitors to this regimen has been proposed to enhance antitumor efficacy. This updated systematic review, and meta-analysis aims to compare the effectiveness and safety of TACE plus lenvatinib combined with PD-1 inhibitors versus TACE plus lenvatinib alone in patients with unresectable HCC.

Materials and Methods:

A comprehensive literature search was conducted in PubMed, EMBASE, Web of Science, Scopus, the Cochrane Library, and the China National Knowledge Infrastructure (CNKI) databases up to September 18, 2024. Studies comparing the triple therapy group versus the double therapy group in uHCC patients were included based on predefined inclusion and exclusion criteria. The primary outcomes were overall survival (OS) and progression-free survival (PFS). Secondary outcomes included objective response rate (ORR), disease control rate (DCR), and incidence of adverse events (AEs). Hazard ratios (HRs) and risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using appropriate statistical models.

Results:

A total of 14 studies involving 1589 patients met the inclusion criteria. The triple therapy group showed a significant improvement in OS (HR = 0.50, 95% CI: 0.41–0.62, p < 0.05) and PFS (HR = 0.52, 95% CI: 0.45–0.59, p < 0.05) compared to the double therapy group. Additionally, the ORR was significantly higher in the triple therapy group (RR = 1.61, 95% CI: 1.4–1.88), as was the DCR (RR = 1.32, 95% CI: 1.23–1.47).

Conclusion:

The combination of TACE plus lenvatinib and PD-1 inhibitors significantly improves survival outcomes, tumor response rates, and disease control rates in patients with uHCC. These findings support the integration of PD-1 inhibitors into combination therapies for uHCC to enhance treatment efficacy.