Effective Transarterial Chemoembolization, Lenvatinb, and Sintilimab Combo in HCC

Article

A safe and tolerable treatment option of transarterial chemoembolization combined with lenvatinib plus sintilimab was given to patients with hepatocellular carcinoma.

Transarterial chemoembolization (TACE) with lenvatinib (Lenvima) plus sintilimab may be a safe and tolerable treatment option for patients with unresectable hepatocellular carcinoma (HCC), according to a presentation from the 2022 Gastrointestinal Cancers Symposium.

Previously, combination therapies for the treatment of this patient population have demonstrated favorable results including PD-1 inhibitors plus lenvatinib and TACE plus lenvatinib. However, the three therapies combined had not yet been investigated for patients with unresectable HCC. The aim of this study was to discover the safety and efficacy of TACE combined with lenvatinib plus sintilimab.

In this single-arm retrospective study, researchers analyzed data from 52 patients diagnosed with HCC who received either 12 mg or 8 mg of lenvatinib — based on body weight — once orally 2 weeks before undergoing TACE. Sintilimab was administered intravenously at 200 mg on day 1 of a 21-day cycle following TACE. The TACE procedure was then repeated 4 to 6 weeks later.

The primary endpoints included objective response rate (ORR) and duration of response (DOR), both of which were assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST).

The analysis included data from 52 patients who were diagnosed with Barcelona Clinic Live Cancer (BCLC) stage B (25%) or C (75%) disease. Patients were mostly men (86.4%) aged 65 years or younger (76.7%). In addition, 13.5% of patients had an ECOG performance status of 0 whereas 86.5% had an ECOG performance status of 1.

After a 12.5-month median follow-up (95% CI, 9.1-14.8), patients had an ORR of 46.7% (28/60: complete response, n = 4; partial response, n = 24). Twenty-three patients in this study had stable disease whereas 9 patients had progressive disease. The median DOR for confirmed respondents was 10 months (95% CI, 9.0-11.0).

Additionally, patients had a median progression-free survival was 13.3 months (95% CI, 11.9-14.7) and an overall survival of 23.6 months (95% CI, 22.2-25.0).

Any-grade adverse events occurred in 84.6% (n = 44) of patients, with the most common events related to treatment including fatigue (30.8%), hypertension (25%), diarrhea (19.2%), decreased appetite (23%) and palmar-plantar erythrodysesthesia (21.1%).

“Randomized-controlled trials of TACE combined with lenvatinib plus sintilimab versus lenvatinib plus sintilimab should be performed to confirm the efficacy and safety of this regimen,” the researchers wrote in the poster.

Reference

Cao F, Yang Y, Si T, et al. Effectiveness of transarterial chemoembolization combined with lenvatinib plus sintilimab in unresectable hepatocellular carcinoma. Presented at the 2022 American Society of Clinical Oncology Gastrointestinal Conference. Abstract 414.

Related Videos
Barbara Smith, MD, PhD, spoke about the potential use of pegulicianine-guided breast cancer surgery based on reports from the phase 3 INSITE trial.
Patient-reported symptoms following surgery appear to improve with the use of perioperative telemonitoring, says Kelly M. Mahuron, MD.
Treatment options in the refractory setting must improve for patients with resected colorectal cancer peritoneal metastasis, says Muhammad Talha Waheed, MD.
Although immature, overall survival data from the KEYNOTE-868 trial may support the use of pembrolizumab plus chemotherapy in patients with endometrial cancer.
Dostarlimab plus chemotherapy appears to yield favorable overall survival in patients with mismatch repair proficient endometrial cancer.
Some patients with large B-cell lymphoma may have to travel a great distance for an initial evaluation for CAR T-cell therapy.
Brian Slomovitz, MD, MS, FACOG discusses the use of new antibody drug conjugates for treating patients with various gynecologic cancers.
Education is essential to referring oncologists manage toxicities associated with CAR T-cell therapy for patients with large B-cell lymphoma.
There is no absolute age cutoff where CAR T cells are contraindicated for those with large B-cell lymphoma, says David L. Porter, MD.
David L. Porter, MD, emphasizes referring patients with large B-cell lymphoma early for CAR T-cell therapy consultation.
Related Content