Phase 3 trial of addition of transarterial chemoembolization to adjuvant sorafenib for hepatocellular carcinoma with portal vein tumor thrombus

Selected patients with hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) could benefit from surgical resection, and postoperative therapy may lower the incidence of tumor recurrence. A phase 3 trial at 5 centers in China evaluated addition of transarterial chemoembolization (TACE) to adjuvant sorafenib after resection in patients with HCC with PVTT. In this randomized trial including 158 patients, both the median recurrence-free survival and the median overall survival were significantly longer with TACE plus sorafenib than with sorafenib alone. The TACE plus sorafenib group did not show additional toxicity compared with the sorafenib alone group. The authors conclude that addition of TACE to sorafenib as postoperative therapy in patients with HCC and PVTT resulted in improved recurrence-free survival and overall survival and was well tolerated (visual abstract).