HAIC combined with lenvatinib and tislelizumab for HCC with concurrent PVTT and pulmonary metastasis: a multicenter propensity score matching analysis.

Authors

Song Chen, Zhiqiang Wu, Yi Xiao, Xiongying Jiang, Feng Shi, Ning Wang, Fangzeng Lin, Guosheng Tan, Wenquan Zhuang, Yonghui Huang

Published in

Therapeutic advances in medical oncology. Volume 18. Pages 17588359261472766. Epub Jul 31, 2026.

Abstract

Patients with hepatocellular carcinoma (HCC) presenting with both portal vein tumor thrombus (PVTT) and pulmonary metastasis (PM) have a particularly poor prognosis and limited treatment options. Hepatic arterial infusion chemotherapy (HAIC)-based combination therapy has shown promising activity in advanced HCC, but evidence in this high-risk population remains limited.
To evaluate the efficacy and safety of HAIC combined with lenvatinib and tislelizumab (HLP) in patients with HCC with concurrent PVTT and PM.
Multicenter retrospective cohort study with propensity score matching (PSM).
Treatment-naïve patients with HCC with concurrent PVTT and PM who received lenvatinib plus tislelizumab (LP), with or without HAIC, between June 2018 and June 2024 were included. PSM was performed to balance baseline characteristics between treatment groups. The primary endpoint was overall survival (OS). Secondary endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs).
A total of 262 patients were enrolled, including 114 patients in the HLP group and 148 patients in the LP group. After 1:1 PSM, 96 matched pairs were analyzed. The HLP group achieved significantly longer median OS than the LP group (15.1 vs 7.0 months; hazard ratio (HR), 0.55; 95% confidence interval (CI), 0.40-0.76; p < 0.001) and longer median PFS (7.3 vs 3.7 months; HR, 0.77; 95% CI, 0.56-0.94; p = 0.033). The ORR (47.7% vs 19.8%; p < 0.001) and DCR (86.1% vs 49.0%; p < 0.001) were also significantly higher in the HLP group. Although both all-grade and grade 3/4 treatment-related AEs were more frequent in the HLP group, toxicities were manageable, and no grade 5 AEs were observed.
In patients with HCC with concurrent PVTT and PM, HLP was associated with improved survival outcomes and tumor response compared with lenvatinib plus tislelizumab alone, with a manageable safety profile.

PMID:
42542804
Bibliographic data and abstract were imported from PubMed on 02 Aug 2026.

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