Clinical efficacy and safety of drug-eluting bead transarterial chemoembolization combined with targeted therapy and immune checkpoint inhibitors in the treatment of intermediate-to-advanced hepatocellular carcinoma

Abstract

Objective: To investigate the clinical efficacy and safety of drug-eluting bead transarterial chemoembolization(DEB-TACE) combined with targeted therapy and immune checkpoint inhibitors(ICIs) in patients with intermediate-to-advanced hepatocellular carcinoma(HCC).

Methodology: The clinical data of one hundred patients with intermediate-to-advanced HCC treated at The Affiliated Hospital of Hebei University between January 2021 to January 2024 were retrospectively analyzed. Patients were divided into the control group(n = 50) and the observation group(n = 50) according to the treatment regimen. The control group received DEB-TACE plus the targeted therapy lenvatinib, whereas the observation group was administered DEB-TACE plus lenvatinib and the ICI pembrolizumab. Clinical efficacy was assessed, adverse reactions occurring during the treatment period were recorded. Progression-free survival(PFS), overall survival(OS) and the cumulative survival rate (CSR) were compared between groups.

Results: The observation group demonstrated significantly higher ORR and LCR compared with the control group (both P < 0.05). After treatment, serum CEA, CA199 and AFP levels were significantly reduced in both groups (all P < 0.05), with greater reductions observed in the observation group (P < 0.05). Post-treatment CD3+, CD8+ and CD4+ T-cell levels increased significantly in both groups (all P < 0.05), with higher levels in the observation group than in the control group(P < 0.05). The ARR did not differ significantly between groups (P > 0.05). No significant differences were observed in PFS or PFSR between groups(both P > 0.05).

Conclusion: The combined use of DEB-TACE, targeted therapy and an ICI demonstrates superior clinical efficacy and a favorable safety profile, which can reduce tumor marker levels, enhance immune function and prolong OS in patients with intermediate-to-advanced HCC.