Adebrelimab plus interventional and targeted therapy for unresectable hepatocellular carcinoma: A single-arm, real-world study.

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Background: Systemic therapy with immune checkpoint inhibitors (ICIs) and targeted agents, in combination with interventional therapy, has become a standard treatment strategy for advanced hepatocellular carcinoma (HCC). However, clinical evidence for PD-L1 inhibitor–based combination regimens in HCC remains limited, particularly in real-world settings. This study reports preliminary real-world outcomes of adebrelimab (a PD-L1 inhibitor) combined with targeted therapy and interventional treatment in patients with unresectable HCC. Methods: Patients with treatment-naïve unresectable HCC (CNLC Ib–IIIb; Child–Pugh A/B; ECOG PS 0–2) were enrolled. All patients received adebrelimab (1200 mg, IV, Q3W) in combination with targeted agents and interventional therapy. Interventional therapy, including transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), or other procedures, was selected by investigators according to tumor burden and clinical status. Targeted agents included, but were not limited to, monoclonal antibodies such as bevacizumab and small-molecule targeted therapies (TKIs) such as lenvatinib. The primary endpoint was objective response rate (ORR). The secondary endpoints were progression-free survival (PFS), disease control rate (DCR), overall survival (OS), and safety. Results: As of January 2026, 13 patients were enrolled. The median age was 57 years (range, 48–74), and 85% were male. Most patients had advanced disease (CNLC IIIA, 77%), Child–Pugh class A/B liver function (38%/62%), and high tumor burden (77% beyond up-to-7). Chronic viral hepatitis (HBV or HCV) was present in 85% of patients, reflecting real-world HCC characteristics in China. Regarding interventional therapy, 9 patients (70%) received TACE, 3 (23%) received HAIC, and 1 underwent ablation. For targeted therapy, 7 patients (54%) received bevacizumab and 6 (46%) received lenvatinib. The median treatment duration was 4.7 months (range, 0.7–13.4). Among 13 patients evaluable for response, 3 achieved partial response, 8 had stable disease, and 2 had progressive disease, yielding an ORR of 23.1% and a DCR of 84.6%. Median PFS and OS were not reached at the time of analysis. Grade ≥3 treatment-related adverse events occurred in 5 patients, mainly neutropenia, leukopenia, and thrombocytopenia. Conclusions: In a real-world setting, adebrelimab (PD-L1)–based immune–targeted systemic therapy plus interventional treatment showed encouraging antitumor activity with manageable toxicity in patients with unresectable HCC. Clinical trial information: ChiCTR2400091083 .