Multicenter, retrospective GUIDANCE001 study comparing transarterial chemoembolization with or without tyrosine kinase and immune checkpoint inhibitors as conversion therapy to treat unresectable hepatocellular carcinoma: Survival benefit in intermed
Da-Long Yang, Lin Ye, Fan-Jian Zeng, Jie Liu, Hong-Bing Yao, Jun-Liang Nong, Shao-Ping Liu, Ning Peng, Wen-Feng Li, Pei-Sheng Wu, Chuang Qin, Ze Su, Jun-Jie Ou, Xiao-Feng Dong, Yi-He Yan, Teng-Meng Zhong, Xian-Shuang Mao, Ming-Song Wu, Yao-Zhi Chen, Guo-Dong Wang, Mian-Jing Li, Xue-Yao Wang, Fu-Quan Yang, Yong-Rong Liang, Shu-Chang Chen, Yong-Yu Yang, Kang Chen, Fu-Xin Li, Yong-Cheng Lai, Qing-Qing Pang, Xiu-Mei Liang, Xue-Mei You, Bang-De Xiang, Ya-Qun Yu, Liang Ma, Jian-Hong Zhong,Background and Aims:
Various conversion therapy options have become available to patients with unresectable HCC, but which conversion therapy is optimal for which type of patient is controversial. This study compared the efficacy and safety of TACE alone or combined with immune checkpoint and tyrosine kinase inhibitors.
Approach and Results:
Data were retrospectively compared for patients with initially unresectable HCC who underwent conversion therapy consisting of TACE alone (n=459) or combined with immune checkpoint and tyrosine kinase inhibitors (n=343). Compared to the group that received TACE alone, the group that received triple conversion therapy showed significantly higher rates of overall survival (HR 0.43, 95%CI 0.35–0.53). In addition, triple therapy was associated with significantly longer median progression-free survival (15.9 vs. 8.0 mo,
Conclusions:
Combining TACE with immune checkpoint and tyrosine kinase inhibitors was associated with significantly better survival and conversion efficacy than TACE alone among patients with intermediate or advanced unresectable HCC.