Efficacy and safety of lenvatinib‐transcatheter arterial chemoembolization sequential therapy for hepatocellular carcinoma within the up‐to‐seven criteria

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AIM: The efficacy of sequential therapy with lenvatinib and transcatheter arterial chemoembolization (LEN-TACE) has been previously reported. This study aimed to evaluate the efficacy and safety of LEN-TACE compared with TACE in patients with hepatocellular carcinoma (HCC) within the up-to-seven criteria. METHODS: Between 2017 and 2024, 90 patients were enrolled and categorized into either LEN-TACE sequential therapy (n = 32) or TACE (n = 58). After propensity score matching (PSM), patients were categorized into the LEN-TACE (n = 29) and TACE groups (n = 29). Progression-free survival, therapeutic response, and adverse events were assessed. RESULTS: After PSM, although there was no significant difference in the objective response rate (ORR) between the LEN-TACE and TACE groups (ORR 93.1% vs. 82.7%, respectively; p = 0.226), PFS with LEN-TACE was significantly higher than with TACE (10.7 [95% confidence interval (CI): 7.6-NE] months versus 7.1 (95% CI: 4.8-10.0) months, respectively; p = 0.030). In the subanalysis, ORR was significantly different between the groups for nodules other than simple ones (100.0% vs. 62.5%, respectively; p = 0.039). No patients in the LEN-TACE group had disease progression, and the sustained complete response rate was 60% 1 year after TACE treatment. CONCLUSIONS: LEN-TACE sequential therapy may be a beneficial treatment for HCC within the up-to-seven criteria, especially for tumors other than the simple nodular type.

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