ArticleBMC cancer2026
Drug-eluting bead TACE improves the efficacy of HAIC combined with molecular-targeted therapy and anti-PD-1 immunotherapy in large hepatocellular carcinoma with inferior vena cava and/or right atrium tumor thrombus: a multicenter retrospective cohort study.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundTo evaluate the safety and efficacy of combining hepatic arterial infusion chemotherapy (HAIC), molecular-targeted therapy (MTT), and programmed cell death 1 inhibitors (PD-1i) (HAIC-MTT-PD-1i) with or without drug-eluting bead transarterial chemoembolization (dTACE) (dTACE-HAIC-MTT-PD-1i) in large hepatocellular carcinoma (HCC) with tumor thrombus (TT) in the inferior vena cava (IVC) and/or right atrium (RA) (HCC-IVC/RA TT).
methodsWe conducted a multicenter study of patients with large HCC-IVC/RA TT undergoing HAIC-MTT-PD-1i (HMP group) or dTACE-HAIC-MTT-PD-1i (THMP group) between January 01, 2021 and December 31, 2024. Local tumor responses, survival outcomes, and treatment-related adverse events (TRAEs) were analyzed between the two groups.
resultsA total of 113 patients were enrolled, with 62 in the HMP group and 51 in the THMP group. The rates of overall objective response (76.5% vs. 50.0%, P = 0.004) and overall disease control (90.2% vs. 69.4%, P = 0.007) were significantly higher in the THMP group compared to the HMP group. The THMP group achieved a significantly superior median progression-free survival of 11.5 months compared to 8.0 months for the HMP group (P = 0.0050) and a median overall survival of 20.0 months versus 17.0 months (P = 0.0038). TRAEs of any grade and grade 3-4 were similar between the two groups (P > 0.05). No grade 5 TRAEs or treatment-related death were observed in either group.
conclusionsdTACE-HAIC-MTT-PD-1i significantly improved efficacy compared to HAIC-MTT-PD-1i, while maintaining an acceptable safety profile for patients with large HCC-IVC/RA TT. Further RCTs are required to validate the findings.
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