仑伐替尼、PD-1抑制剂联合TACE-HAIC治疗原发性肝癌的临床效果及安全性评估

肝脏 ›› 2026, Vol. 31 ›› Issue (7): 989-993.

仑伐替尼、PD-1抑制剂联合TACE-HAIC治疗原发性肝癌的临床效果及安全性评估

张恒, 邹玲, 李捷, 刘召洪, 张再华, 殷登菊

617023 攀枝花攀钢集团总医院普通外科(张恒,李捷,刘召洪,张再华,殷登菊),消化内科(邹玲)

收稿日期:2025-08-17 出版日期:2026-07-31 发布日期:2026-08-21
通讯作者: 邹玲,Email:ssma551896@yeah.net
基金资助:
四川省抗癌协会临床科研资金(齐鲁专项)(XH 2023 103)

The clinical efficacy and safety assessment of lenvatinib and PD-1 inhibitors combined with TACE-HAIC in the treatment of primary liver cancer

Zhang Heng¹, Zou Ling², Li Jie¹, Liu Zhaohong¹, Zhang Zaihua¹, Yin Dengju¹

1. Department of General surgery,Pangang Group General Hospital, Panzhihua 617023,China;
2. Department of Digestive system, Pangang Group General Hospital, Panzhihua 617023,China

Received:2025-08-17 Online:2026-07-31 Published:2026-08-21
Contact: Zou Ling,Email:ssma551896@yeah.net

摘要/Abstract

摘要： 目的分析仑伐替尼(分组中简写为Len)、PD-1抑制剂联合肝动脉栓塞灌注化疗(TACE-HAIC)在原发性肝癌(PLC)治疗中的临床效果和安全性。方法选择攀钢集团总医院2022年12月—2024年9月治疗的84名中晚期PLC患者,其中行Len+PD-1+TACE-HAIC治疗的患者有49例(58.33%),为观察组;行Len+TACE治疗的35例(41.67%)患者为对照组。收集两组患者的临床数据,比较两组患者采用不同治疗方法后的疗效、不良反应及生存状况。结果观察组和对照组患者在性别、年龄、体质指数、Child-Pugh分级、TACE史、肝炎史、转移和家族史等一般资料上差异均无统计学意义(P>0.05);观察组的肿瘤最大直径显著大于对照组[(6.12±1.42)cm比(5.22±1.20)cm,P=0.003];观察组总生存期显著长于对照组(P<0.001),观察组的无进展生存期显著长于对照组(P<0.05);观察组不良反应发生率低于对照组,差异有统计学意义(P<0.05);与对照组相比,观察组治疗后的总体反应率、疾病控制率更好,分别为38.78%比25.71%,95.92%比71.43%。结论仑伐替尼、PD-1抑制剂联合TACE-HAIC可有效控制PLC的病情进展,延长患者的生存时间且安全性良好。

关键词: 原发性肝癌, TACE, HAIC, 临床疗效

Abstract: Objective To analyze the clinical efficacy and safety of lenvatinib (abbreviated as Len in the group) and PD-1 inhibitor combined with transcatheter arterial chemoembolization and hepatic arterial infusion chemotherapy (TACE-HAIC) in the treatment of primary liver cancer (PLC). Methods A total of 84 patients with middle and advanced primary liver cancer treated from December 2022 to September 2024 at Pangang Group General Hospital were selected. Among them, 49 patients (58.33%) treated with Len+PD-1+TACE-HAIC were included in the observation group, and 35 patients (41.67%) treated with Len+TACE were included in the control group. Clinical data of the two groups were collected and analyzed to compare adverse reactions, efficacy, and survival after different treatment methods. Results There were no significant differences in general information such as gender, age, BMI, Child-Pugh score, history of TACE, history of hepatitis, metastasis, and family history between the observation group and the control group (P>0.05). However, there was a significant difference in the maximum diameter of the tumor, with the observation group having a significantly larger maximum tumor diameter than the control group [(6.12±1.42)cm vs. (5.22±1.20)cm, P=0.003]. According to the follow-up data, the overall survival (OS) of the observation group was significantly higher than that of the control group (P<0.001), and the progression-free survival (PFS) of the observation group was significantly longer than that of the control group (P<0.05). The incidence of adverse reactions in the observation group was lower than that in the control group, with a statistically significant difference (P<0.05). Compared with the control group, the overall response rate and disease control rate after treatment in the observation group were higher than that of the control group: 38.78% vs. 25.71% and 95.92% vs. 71.43%, respectively. Conclusion The combination of lenvatinib, PD-1 inhibitors, and TACE-HAIC can effectively control the progression of primary liver cancer, extend the survival time of patients, and has a good safety profile.

Key words: Primary liver cancer, TACE, HAIC, Clinical efficacy

张恒, 邹玲, 李捷, 刘召洪, 张再华, 殷登菊. 仑伐替尼、PD-1抑制剂联合TACE-HAIC治疗原发性肝癌的临床效果及安全性评估[J]. 肝脏, 2026, 31(7): 989-993.

Zhang Heng, Zou Ling, Li Jie, Liu Zhaohong, Zhang Zaihua, Yin Dengju. The clinical efficacy and safety assessment of lenvatinib and PD-1 inhibitors combined with TACE-HAIC in the treatment of primary liver cancer[J]. Chinese Hepatolgy, 2026, 31(7): 989-993.

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参考文献

[1] Bray F, Ferlay J, Soerjomataram I, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2018, 68(6): 394-424.
[2] 王闯胜, 朱培欣, 石佳. 单纯仑伐替尼靶向治疗原发性与转移性肝癌患者的效果对比研究[J]. 中国合理用药探索, 2023, 20(5): 86-91.
[3] 陈亦晨, 曲晓滨, 孙良红, 等. 2002—2019年上海市浦东新区居民肝癌死亡特征及减寿率分析[J]. 中国全科医学, 2021, 24(12): 1517-1522.
[4] Anwanwan D, Singh S K, Singh S, et al. Challenges in liver cancer and possible treatment approaches[J]. Biochim Biophys Acta Rev Cancer, 2020, 1873(1):188314.
[5] Xing R, Gao J, Cui Q, et al. Strategies to improve the antitumor effect of immunotherapy for hepatocellular carcinoma[J]. Front Immunol, 2021, 12: 783236.
[6] Ji S, Feng L, Fu Z, et al. Pharmaco-proteogenomic characterization of liver cancer organoids for precision oncology[J]. Sci Transl Med, 2023, 15(706): 26.
[7] Kudo M, Finn R S, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial[J]. Lancet, 2018, 391(10126): 1163-1173.
[8] Donne R, Lujambio A. The liver cancer immune microenvironment: therapeutic implications for hepatocellular carcinoma[J]. Hepatology, 2023, 77(5): 1773-1796.
[9] Buttell A,Qiu W. The action and resistance mechanisms of lenvatinib in liver cancer[J]. Mol Carcinog, 2023, 62(12): 1918-1934.
[10] Yi C, Chen L, Lin Z, et al. Lenvatinib targets FGF receptor 4 to enhance antitumor immune response of anti-programmed cell death-1 in HCC[J]. Hepatology, 2021, 74(5): 2544-2560.
[11] Zhou C, Sun B Y, Zhou P Y, et al. MAIT cells confer resistance to Lenvatinib plus anti-PD1 antibodies in hepatocellular carcinoma through TNF-TNFRSF1B pathway[J]. Clin Immunol, 2023, 256(109770): 17.
[12] Li Z C, Wang J, Liu H B, et al. Proteomic and metabolomic features in patients with HCC responding to lenvatinib and anti-PD1 therapy[J]. Cell Rep, 2024, 43(3): 27.
[13] Yang X, Chen B, Wang Y, et al. Real-world efficacy and prognostic factors of lenvatinib plus PD-1 inhibitors in 378 unresectable hepatocellular carcinoma patients[J]. Hepatol Int, 2023, 17(3): 709-719.
[14] Zhang W, Tong S, Hu B, et al. Lenvatinib plus anti-PD-1 antibodies as conversion therapy for patients with unresectable intermediate-advanced hepatocellular carcinoma: a single-arm, phase II trial[J]. J Immunother Cancer, 2023, 11(9): e007366.
[15] Demirtas C O, Ricco G, Ozdogan O C, et al. Practicality and potential restrictions of unresectable hepatocellular carcinoma prognostic index[J].Hepatol Commun, 2022, 6(12): 3600-3601.
[16] Aramaki O, Takayama T, Moriguchi M, et al. Arterial chemoembolisation with cisplatin versus epirubicin for hepatocellular carcinoma (ACE 500 study): a multicentre, randomised controlled phase 2/3 trial[J]. Eur J Cancer, 2021, 157: 373-382.
[17] Sidaway P. HAIC-FO improves outcomes in HCC[J]. Nat Rev Clin Oncol, 2022, 19(3):150.
[18] Yuan Y, He W, Yang Z, et al. TACE-HAIC combined with targeted therapy and immunotherapy versus TACE alone for hepatocellular carcinoma with portal vein tumour thrombus: a propensity score matching study[J]. Int J Surg, 2023, 109(5): 1222-1230.
[19] Liu J, Zhang J, Wang Y, et al. HAIC versus TACE for patients with unresectable hepatocellular carcinoma: a systematic review and meta-analysis[J].Medicine (Baltimore). 2022, 101(51):e32390.