Comparison of efficacy and safety between transarterial chemoembolization (TACE) combined with lenvatinib versus TACE combined with sorafenib in the treatment of intermediate and advanced hepatocellular carcinoma.

OBJECTIVE

To compare the clinical effect and safety of transcatheter arterial chemoembolization (TACE) combined with lenvatinib versus TACE combined with sorafenib in the treatment of intermediate-advanced hepatocellular carcinoma.

METHODS

In this retrospective study, 84 patients with intermediate-advanced hepatocellular carcinoma admitted to the First Affiliated Hospital of Anhui Medical University and the First Affiliated Hospital of USTC from June 2019 to June 2021 were enrolled. The control group was given TACE combined with sorafenib, and the experimental group was given TACE combined with lenvatinib. The clinical efficacy, tumor markers, liver function indexes, and occurrence of toxic and side effects were compared between the two groups.

RESULTS

The disease control rate (DCR) and the objective remission rate (ORR) of the experimental group was higher than that of the control group, and the difference was statistically significant (P<0.05). Before treatment, there were no significant differences in the levels of alpha fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP) between the two groups (both P>0.05); after the treatment, the levels of AFP and DCP in both groups decreased, and those in the experimental group were lower than the control group (all P<0.05). Before treatment, there were no significant differences in the levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST) or lactate dehydrogenase (LDH), bilirubin (BIL) between the two groups (all P>0.05); after treatment, the levels of ALT, AST and LDH, BIL in both groups decreased, with the experimental group lower than the control group (all P<0.05). The overall survival (OS) and progression-free survival (PFS) in the experimental group were significantly higher than in the control group (both P<0.05). The incidences of symptoms of diarrhea, hand-foot syndrome, hypertension and rash in the experimental group were higher than those in the control group (all P<0.05). Fatigue, digestive tract reaction, bone marrow suppression and abnormal liver function of the two groups were similar (all P>0.05).

CONCLUSION

Compared with TACE plus sorafenib, TACE plus lenvatinib can better control disease progression, reduce the levels of tumor markers, and stabilize the liver function of patients with intermediate-advanced hepatocellular carcinoma.