ArticleBMC gastroenterology2026
Transarterial chemoembolization combined with tyrosine kinase inhibitors and programmed death-1 inhibitors in recurrent intermediate and advanced hepatocellular carcinoma: a single-centre retrospective cohort study.
Article in BMC gastroenterology, 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
backgroundWe aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) plus tyrosine-kinase inhibitors (TKIs) with or without programmed death-1 (PD-1) inhibitors in recurrent intermediate-advanced hepatocellular carcinoma (HCC). MATERIALS AND
methodsIn this retrospective, single-center cohort study (January 2016-January 2024), 39 consecutive patients with recurrent HCC (BCLC B/C) received TACE combined with (1) regorafenib (n = 14), (2) lenvatinib + PD-1 inhibitor (n = 12), or (3) regorafenib + PD-1 inhibitor (n = 13). Overall survival (OS) and progression-free survival (PFS) were primary outcomes. Objective response rate (ORR) and disease control rate (DCR) were secondary. Multivariable Cox regression and propensity score matching analyses were performed. A post-hoc power analysis was conducted to quantify statistical power.
resultsMedian follow-up was 36.5 months. Median OS and PFS for the entire cohort were 42.9 months (95% CI 27.1-58.7) and 16.5 months (95% CI 13.6-19.5), respectively. No significant differences in OS (P = 0.164) or PFS (P = 0.830) were observed among the three groups. ORR was 12.8% and DCR 51.3%. BCLC stage B (vs. C) was an independent favorable prognostic factor for OS (HR 0.03, P = 0.01) and PFS (HR 0.04, P = 0.038). Grade ≥ 3 adverse events occurred in 2 (5.1%) patients. The median number of TACE sessions was 4 (IQR 3-6) for Group A, 5 (IQR 3-7) for Group B, and 4 (IQR 3-5) for Group C (P = 0.72).
conclusionTACE plus TKIs with or without PD-1 inhibitors showed acceptable efficacy and safety in recurrent intermediate-advanced HCC. The addition of PD-1 inhibitors did not demonstrate additional survival benefit in this small cohort. However, the present sample size was underpowered to detect a clinically meaningful but modest survival difference. Prospective randomized trials are warranted.
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