Transarterial chemoembolization (TACE) combined with sintilimab and bevacizumab versus TACE alone in patients with Barcelona Clinic Liver Cancer stage B unresectable hepatocellular carcinoma: A retrospective, propensity score-matched analysis.

Abstract

506 Background: The efficacy of transarterial chemoembolization (TACE) in Barcelona Clinic Liver Cancer stage B(BCLC-B stage) hepatocellular carcinoma (HCC) patients is partially unsatisfactory. Systemic therapy and TACE are widely used in BCLC-B stage HCC patients. This study aims to explore the efficacy of combining systemic therapy with transarterial-based therapy in unresectable BCLC-B stage HCC patients. Methods: A total of 76 newly diagnosed HCC patients with BCLC-B stage were included in this retrospective cohort study. These patients were divided into two groups: TACE combined with Sintilimab and bevacizumab group (TACE+ group, n=38) and TACE monotherapy group (TACE group, n= 38). Propensity score matching was used to account for potential confounding factors. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), liver function, and adverse events (AEs) were recorded and evaluated. Results: After propensity score matching, 25 patients were assigned to each group. The TACE+ group showed longer median PFS (10.0 vs. 5.5 months, HR:0.24, P<0.001) than the TACE group. The TACE+ group showed better OS than the TACE group (median OS not reached vs. 19.4 months, HR:0.40, P =0.028). There was no significant difference in overall response rate [80% (20/25) vs. 64% (16/25), P=0.173] and disease control rate [88% (22/25) vs. 72% (18/25), P=0.145] between the two groups. The grade 3/4 adverse events rates were similar between the two groups (19.3% vs. 25.4%, P=0.082). Conclusions: The combination of TACE, Sintilimab and bevacizumab provides clinical benefits for patients with intermediate HCC, has an acceptable safety profile, shows a trend towards improving liver function, and does not increase the occurrence of grade 3-4 AEs.