Efficacy and safety of transarterial chemoembolization (TACE) with tislelizumab and tyrosine kinase inhibitors versus TACE for intermediate and advanced HCC.

Résumé

BACKGROUND & AIMS: Transarterial chemoembolization (TACE) combined with targeted therapy and immunotherapy is a promising approach for intermediate and advanced hepatocellular carcinoma (HCC). This study aimed to compare the efficacy and safety of TACE plus tislelizumab and tyrosine kinase inhibitors (TKIs) versus TACE alone.METHODS: This retrospective study analyzed patients with intermediate and advanced HCC treated from February 2018 to September 2023. Patients were divided into two groups: the combination therapy group (TACE plus tislelizumab and TKIs) and the monotherapy group (TACE alone). The primary endpoint was progression-free survival PFS), and secondary endpoints included objective response rate (ORR), disease control rate (DCR), overall survival (OS), and safety. Cox regression, sensitivity analysis, Kaplan-Meier survival curves, and restricted mean survival time (RMST) analysis were performed to assess the robustness of the PFS benefit.RESULTS: A total of 62 patients were included (30 in the combination group, 32 in the monotherapy group), with balanced baseline characteristics. After a median follow-up of 33.3 months, median PFS was 11.7 months in the combination group and 3.8 months in the monotherapy group (hazard ratio [HR], 0.43; 95% confidence interval [CI], 0.24-0.77; P = 0.0034). This benefit persisted after multivariable adjustment (adjusted HR, 0.28; 95% CI 0.14-0.57; P