Clinical Efficacy Of Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Monoclonal Antibody And Lenvatinib For Middle-advanced Stage Hepatocellular Carcinoma

Objective:To investigate the efficacy and safety of hepatic arterial infusion chemotherapy(HAIC)combined with programmed cell death-1(PD-1)monoclonal antibody and lenvatinib in the treatment of patients with middle-advanced stage hepatocellular carcinoma.Methods:The clinical data of 61 patients with middle-advanced stage hepatocellular carcinoma who were treated with HAIC combined with PD-1 monoclonal antibody and lenvatinib in the Second Affiliated Hospital of Nanchang University from September 2020 to January 2022 were retrospectively analyzed.The efficacy was evaluated based on RECIST 1.1 and m RECIST,and the safety was evaluated by CTCAE 5.0.Progression-free survival(PFS)was calculated by the Kaplan-Meier method,and prognostic factors were analyzed by the Cox regression model.Results:1.The overall response rate(ORR)of HAIC combined with PD-1 monoclonal antibody and lenvatinib in patients with middle-advanced stage hepatocellular carcinoma was 36.1%(RECIST1.1)and 57.4%(m RECIST),and the disease control rate(DCR)was 82.0%.Among them,the ORR of first-line treatment patients was 44.7% and 66.0%,DCR was 83.0%,the ORR of second-line treatment patients was 7.1% and 28.6%,DCR was 78.6%.2.The median PFS of patients with middle-advanced stage hepatocellular carcinoma treated with HAIC combined with PD-1 monoclonal antibody and lenvatinib was6.0 months.The median PFS of first-line treatment patients was 6.7 months and second-line treatment patients was 4.3 months.3.The overall incidence of adverse reactions in this study was 75.4 %(46/61).Common adverse events included neutropenia 50.8 %(31/61),abdominal pain45.9 %(28/61)and elevated alanine aminotransferase 39.3 %(24/ 61).Of the 61 patients,16(26.2 %)had serious adverse events(grade 3-4).The common serious adverse reactions included abdominal pain 8.2 %(5/61),neutropenia 6.6 %(4/61)and thrombocytopenia 4.9 %(3/61).4.Univariate and multivariate analysis showed that treatment line and age were the independent prognostic factors of PFS in patients with middle-advanced stage hepatocellular carcinoma treated with HAIC combined with PD-1 monoclonal antibody and lenvatinib(p <0.05).Conclusion:HAIC combined with PD-1 monoclonal antibody and lenvatinib in the treatment of middle-advanced stage hepatocellular carcinoma has a positive short-term effect,and the adverse reactions are generally controllable.