ArticleHepatology (Baltimore, Md.)2026
Comparative effectiveness of immunotherapy versus lenvatinib in advanced hepatocellular carcinoma: A real-world analysis using target trial emulation.
Article in Hepatology (Baltimore, Md.), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed.
- The versatile interplay between steatotic liver disease and liver cancer.Nature reviews. Cancer · 2026Review
- Review
- Lenvatinib combined with immune checkpoint inhibitors for unresectable, recurrent, or metastatic hepatocellular carcinoma: a real-world study.The oncologist · 2026Article
- Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma.Current oncology (Toronto, Ont.) · 2026Article
- Design and Implementation of Observational Studies Emulating a Target Trial.JAMA network open · 2026Article
- SGLT-2 Inhibitor use and liver-related and mortality outcomes in patients with type 2 diabetes and compensated cirrhosis.BMC medicine · 2026Article
- Lenvatinib continuation versus regorafenib in treating hepatocellular carcinoma after lenvatinib failure.Quantitative imaging in medicine and surgery · 2026Article
- Immunotherapy versus lenvatinib in advanced hepatocellular carcinoma: The critical role of subgroup analyses.iLIVER · 2025Article
- Effect of varenicline on major adverse liver outcomes in alcohol-associated liver disease: An exploratory analysis.Alcohol, clinical & experimental research · 2025Article
- Immunotherapy versus lenvatinib in hepatocellular carcinoma: the need for granular data and prospective validation.Journal for immunotherapy of cancer · 2025Article
- Impact of Antiviral Treatment on Survival in HBV-Related Intrahepatic Cholangiocarcinoma Patients After Hepatectomy: A 14-Year Retrospective Follow-Up Study Based on the Propensity Score Matching Method.Therapeutics and clinical risk management · 2025Article
- Machine Learning-Based Survival Analysis for Patients Receiving Lenvatinib for Unresectable Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
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14 authors.
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Abstract
BACKGROUND AND
aimsImmunotherapy has emerged as an effective treatment for advanced HCC. We aimed to investigate the real-world effectiveness of immunotherapy compared to lenvatinib in HCC. APPROACH AND
resultsFrom the TriNetX database, we used a target trial emulation framework and identified patients with HCC who received first-line treatment with immunotherapy (atezolizumab/bevacizumab or tremelimumab/durvalumab) or lenvatinib between or between August 2018 and December 2023. OS was compared using Kaplan-Meier analysis and Cox proportional hazards regression. After propensity score matching, 1203 patients were included in each group. Immunotherapy was associated with improved OS versus lenvatinib (median survival: 545 vs. 425 d; HR: 0.86, 95% CI: 0.76-0.97). Regarding treatment type, atezolizumab plus bevacizumab showed improved survival compared to lenvatinib (n=1070 in each group; HR: 0.87, 95% CI: 0.77-0.99), while the point estimate favored durvalumab plus tremelimumab versus lenvatinib (HR: 0.81, 95% CI: 0.59-1.12), though this difference was not statistically significant, likely due to small sample size. Regarding etiology, immunotherapy had improved OS compared to lenvatinib in viral hepatitis (n=510 in each group; HR: 0.74, 95% CI: 0.61-0.89) and alcohol-associated liver disease (n=190 in each group; HR: 0.65, 95% CI: 0.49-0.87), but not in metabolic dysfunction-associated steatotic liver diseases (n=156 in each group; HR: 0.96, 95% CI: 0.70-1.31).
conclusionsIn this real-world analysis, immunotherapy was associated with improved OS compared to lenvatinib in advanced HCC, with consistent benefit across most subgroups. These findings support the use of immunotherapy as a first-line treatment for advanced HCC.
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