Conversion therapy using transarterial chemoembolization plus tislelizumab for unresectable hepatocellular carcinoma: effects on tumor necrosis and anti-tumor immune response.

Résumé

PURPOSE: We analyzed the clinical efficacy and safety of conversion therapy for unresectable hepatocellular carcinoma (uHCC) using transarterial chemoembolization (TACE) plus tislelizumab and characterized its effects on the tumor and immune landscape.METHODS: Fifty-seven patients with uHCC undergoing TACE plus tislelizumab from March 2020 to October 2024 were potentially eligible, and thirty-two patients finally enrolled. The efficacy endpoints included successful conversion rate, objective response rate (ORR), overall survival (OS), and progression-free survival (PFS). Tumor response was assessed using modified Response Evaluation Criteria in Solid Tumors (mRECIST). Treatment-related adverse events (TRAEs) were recorded according to CTCAE v5.0. Hematoxylin and eosin (HE) staining was used to evaluate tumor necrosis and lymphocyte infiltration. Immunohistochemistry (IHC) was performed to differentiate tumor immune infiltrates via a set of markers.RESULTS: The best overall responses were 9.4% CR, 46.9% PR, 37.5% SD, and 6.3% PD, the ORR was 56.3%. Better ORR was shown in patients with AFP ≥ 400 ng/mL or tumor number