A recent study has found that transarterial radioembolization (TARE) offers longer survival for patients with hepatocellular carcinoma (HCC) accompanied by portal vein tumor thrombus (PVTT) compared to combination therapy with atezolizumab and bevacizumab.
HCC, particularly when it invades the liver's major blood vessels, is challenging to treat and has a poor prognosis. Without treatment, patients with PVTT typically have an average survival of only three months.
A research team led by Professor Kim Yoon-jun at Seoul National University Hospital conducted a multicenter study comparing treatment outcomes between 213 patients with HCC and PVTT who received TARE and those who underwent atezolizumab-bevacizumab therapy from 2016 to 2023. The findings were announced on June 24.
The team analyzed overall survival, progression-free survival, objective response rate (ORR), and safety by dividing patients into TARE and atezolizumab-bevacizumab groups. To account for differences in baseline characteristics, inverse probability weighting and propensity score matching were applied.
The median overall survival was 27.5 months for the TARE group, significantly longer than the 8.6 months observed in the atezolizumab-bevacizumab group. Notably, in patients whose cancer had not yet progressed to the main portal vein (involvement at the segmental or lobe level), the risk of death in the TARE group was 36% lower compared to the atezolizumab-bevacizumab group. However, no significant differences were found between the two treatments in patients with main portal vein involvement.
There were no significant differences in progression-free survival or tumor response rates between the two treatment groups.
In terms of safety, the TARE group showed a trend toward lower rates of certain adverse reactions. The incidence of ascites affecting daily life was 12% in the TARE group compared to 20.5% in the atezolizumab-bevacizumab group, while variceal bleeding rates were 1.7% and 8%, respectively.
Professor Kim stated, "TARE is significant for sequential personalized treatment strategies in advanced liver cancer, as it relatively maintains liver function, allowing for subsequent chemotherapy."
The study results have been published in the latest issue of the international journal 'Diagnostic and Interventional Imaging.'
* This article has been translated by AI.
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