Discussion
tumor, Tumor, unresectable HCC, portal vein cancer embolism, HCC
TUMOR, TUMOR, LIVER CANCER, ADVERSE EVENTS, TUMOR PROGRESSION
TACE is currently the standard first-line treatment for mid-stage HCC recommended by various guidelines around the world (In recent years, immunotherapy has achieved the obvious curative effect in the field of liver cancer (This study evaluated the efficacy and safety of TACE + TKI + PD-1 antibody in the treatment of unresectable HCC and explored the factors influencing its prognosis. The median OS was not reached, and the median PFS was 10.5 months (95% CI 7.8-13.1), the ORR was 35.6% and the DCR was 87.4% (RECIST version 1.1), higher than the previous PD-1 inhibitors or TKI monotherapy, and higher than RESCUE study results (Subgroup analyses of ORR and PFS based on baseline characteristics found that combination with lenvatinib showed better benefits than combination with sorafenib in the triple therapy, which was consistent with the results of the REFLECT study (Tumor burden and portal vein cancer embolism are factors for poor prognosis of patients with advanced liver cancer. Effective therapeutic approaches must be explored to control tumor progression, reduce tumor volume, and improve patient prognosis. Therefore, transformation therapy has become a research hotspot for unresectable HCC and middle and advanced HCC (The safety profile of triple therapy was consistent with those of the individual drugs. No new safety signals were observed. But all of these adverse events are generally manageable. Notably, compared with camrelizumab monotherapy, the incidence of RCCEP was reduced in combination therapy, which may be due to the involvement of VEGF signaling pathways in the mechanism of RCCEP, and other studies reported similar findings (There are several limitations to this study. First, the sample size of this study is relatively small, which may reduce the statistical efficacy. Second, the follow-up time in this study was short, and a longer follow-up time was needed to verify the further OS. Third, there were few cases in the combination timing group, and finding the right combination therapy timing is still necessary.