Transarterial chemoembolization combined with lenvatinib versus transarterial chemoembolization combined with sorafenib for unresectable hepatocellular carcinoma: A comparative retrospective study.

Aim: Tyrosine kinase inhibitors target transarterial chemoembolization (TACE)‐mediated vascular endothelial growth factor to inhibit tumor revascularization and to slow tumor progression. The present study aimed to compare the clinical outcomes of TACE combined with lenvatinib (TACE‐lenvatinib) and TACE combined with sorafenib (TACE‐sorafenib) in patients with unresectable hepatocellular carcinoma (HCC). Methods: The clinical data of patients diagnosed with unresectable HCC who received TACE‐lenvatinib or TACE‐sorafenib between January 2018 and April 2021 were retrospectively reviewed. The tumor response, progression‐free survival (PFS), overall survival (OS), and adverse events (AEs) were evaluated and compared between the two groups. Results: A total of 112 patients were enrolled and classified into the TACE‐lenvatinib group (n = 53) and the TACE‐sorafenib group (n = 59). The objective response rates of patients in the TACE‐lenvatinib and TACE‐sorafenib groups were 54.7% and 44.1%, respectively (p = 0.260), and the disease control rates (DCRs) were 81.1% and 61.0% (p = 0.020). The median PFS time was significantly longer in the TACE‐lenvatinib group than in the TACE‐sorafenib group (10.7 vs. 6.0 months; p = 0.002). The median OS time between the TACE‐lenvatinib and TACE‐sorafenib groups also showed a significant difference (30.5 vs. 20.5 months, p = 0.018). All treatment‐related AEs and grade 3/4 AEs were comparable between the two groups (p > 0.05). Conclusion: Compared to TACE‐sorafenib, TACE‐lenvatinib was associated with better DCR, PFS and OS outcomes in patients with unresectable HCC. In subgroups of Barcelona Clinic Liver Cancer B stage or TACE‐refractory patients, TACE‐lenvatinib also showed a trend of superiority. [ABSTRACT FROM AUTHOR]