Postprogression lenvatinib with or without PD-1 inhibitor for advanced hepatocellular carcinoma refractory to hepatic arterial infusion chemotherapy

A trial at Sun Yat-sen University (Guangzhou, China) compared postprogression lenvatinib plus PD-1 inhibitor versus lenvatinib alone for advanced hepatocellular carcinoma (aHCC) refractory to hepatic arterial infusion chemotherapy (HAIC) based on modified RECIST criteria. After 1:1 propensity score matching the median OS was 43.6 months in the group with HAIC plus lenvatinib plus PD-1 inhibitor versus 18.9 months in the group with HAIC plus lenvatinib (p=0.009). The median PFS was 35.6 versus 9.4 months in the two groups (p=0.009). In multivariate analysis, factors significantly affecting OS were aFP, early response to HAIC, and HAIC-lenvatinib treatment, while factors significantly affecting PFS were modified albumin-bilirubin grade, early response to HAIC, and HAIC-lenvatinib treatment. The authors conclude that combination therapy with PD-1 inhibitor plus lenvatinib has promising survival benefits in the management of patients with aHCC refractory to HAIC.