Abstract
BACKGROUND: There is relatively scant evidence concerning the effects of Lenvatinib and Pembrolizumab together with TACE for advanced HCC Lenvatinib and pembrolizumab have been widely applied in clinical settings. PIVKA-II serving as the sensitive biomarker for evaluating liver cancer was employed by us to further assess the therapeutic effectiveness of TACE combined with Lenvatinib in the treatment of BCLC C. METHODS: In this retrospective study, 260 patients with HCC BCLC C stage were included in the present study. TACE (TL group) included 126 patients, TACE-Lenvatinib-Pembrolizumab (TPB group) consisted of 134 patients. OS and PFS were compared between the two groups. Alternatively, the impact of PIVKA-II in TPB on the PFS of BCLC C stage was also assessed. RESULTS: The median overall survival (OS) in the TL group was significantly prolonged compared to that in the TPB group (13.7 months versus 9.6 months). Conversely, the median progression - free survival (PFS) was extended in the TPB group as opposed to the TL group (9.3 months versus 6.2 months). The adverse events in the TPB group were controllable and tolerable. After six months of combined treatment, the change in PIVKA - II became less significant. This suggests that PIVKA-II is negatively correlated with PFS, meaning that the greater the decrease in PIVKA-II after 6 months of combined therapy, the longer the PFS time for the patient. CONCLUSION: TACE combined with Lenvatinib and Pembrolizumab exhibited remarkable survival benefits for HCC BCLC C patients. Given the extremely dismal prognosis of advanced HCC, the safety and efficacy of TACE in combination with Lenvatinib and Pembrolizumab justify its clinical application.