HAIC-Based versus TACE-Based Triple Therapy with Lenvatinib and PD-1 Inhibitors for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus: A Retrospective Propensity Score-Matched Study.

Authors

Jun Yu, Yiran Xu, Xuehan Shen, Jinpeng Wang, Tianyin Shao, Yu Wu, Hanlong Hu, Qi Cheng, Zhiwei Zhang

Published in

Journal of hepatocellular carcinoma. Volume 13. Pages 623040. Epub Aug 18, 2026.

Abstract

The optimal locoregional treatment to combine with lenvatinib and PD-1 inhibitors for hepatocellular carcinoma with portal vein tumor thrombus (PVTT-HCC) remains uncertain. We compared HAIC- and TACE-based triple therapy.
This retrospective single-center study included 359 consecutive patients with PVTT-HCC treated with HAIC or TACE plus lenvatinib and a PD-1 inhibitor. Propensity score matching (PSM) was performed at a 1:1 ratio. Tumor response was assessed using mRECIST. Overall survival (OS), progression-free survival (PFS), conversion-to-surgery, and adverse events were compared. Time-dependent Cox models accounted for cumulative locoregional treatment sessions.
Among 359 patients, 161 received TACE-based therapy and 198 received HAIC-based therapy. After PSM, 139 matched pairs were analyzed. HAIC was associated with higher objective response rate (66.91% vs 42.45%) and disease control rate (82.73% vs 62.59%) than TACE (both P<0.001). Median OS was 23.7 versus 17.1 months (HR 0.67, 95% CI 0.48-0.93; P=0.018), and median PFS was 7.7 versus 5.4 months (HR 0.70, 95% CI 0.54-0.91; P=0.008), favoring HAIC. After time-dependent adjustment, HAIC remained associated with improved OS (HR 0.61; P=0.003) and PFS (HR 0.73; P=0.011). Conversion-to-surgery was more frequent with HAIC (27.3% vs 17.4%; P=0.027). Overall adverse-event rates were similar (89.90% vs 88.82%; P=0.741), although hypertension was more frequent with HAIC (52.02% vs 38.51%; P=0.011).
In patients with PVTT-HCC receiving lenvatinib and PD-1 inhibitors, HAIC-based triple therapy was associated with improved tumor response and longer OS and PFS than TACE-based therapy, with generally comparable safety. Prospective multicenter studies are warranted.

PMID:
42633413
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.

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