Jing Li,1– 3,* Yaowei Bai,1– 3,* Fu Xiong,1– 3,* Xiaocui Liu,1– 3 Junwen Hu,4 Guilin Zhang,1– 3 Jiayun Liu,1– 3 Suyue Wu,1– 3 Chuansheng Zheng,1– 3 Xuefeng Kan1– 3 

1Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 2Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, 430022, People’s Republic of China; 3Hubei Province Key Laboratory of Molecular Imaging, Wuhan, Hubei, 430022, People’s Republic of China; 4Department of Oncology, The Third People’s Hospital of Yibin, Sichuan, 644000, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Xuefeng Kan, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People’s Republic of China, Email xkliulang1314@163.com Chuansheng Zheng, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People’s Republic of China, Email hqzcsxh@sina.com

Purpose: This study aimed to compare the efficacy and safety of atezolizumab plus bevacizumab (T+A) in combination with transarterial chemoembolization (TACE) (T+A+TACE) and T+A for patients with advanced hepatocellular carcinoma (HCC).
Patients and Methods: From December 2020 to August 2024, 83 patients with advanced HCC who received T+A+TACE treatment or T+A treatment in our hospital were included, and these patients were categorized into TACE+T+A group (n=52) and T+A group (n=31). The clinical outcomes between the two groups were analyzed and compared, and the prognostic factors that affected the efficacy were analyzed.
Results: The median overall survival (OS) and median progression-free survival (PFS) in the T+A+TACE group were significantly longer than those of in the T+A group (OS: 22.8 vs 16.9 months, P = 0.015; PFS: 7.1 vs 4.9 months, P = 0.006). A significantly higher objective response rate (ORR) and disease control rate (DCR) that are based on the modified RECIST were achieved in the T+A+TACE group than those of in the T+A group (ORR: 51.9% vs 6.5%, P < 0.001; DCR: 88.5% vs 54.8%, P < 0.001). No significant differences in adverse events (AEs) were observed between the two groups (P > 0.05). The T+A+TACE treatment was identified as a protective factor for OS and PFS.
Conclusion: TACE further improved the efficacy of T+A treatment for patients with advanced HCC, and it did not increase the incidence of AEs. T+A+TACE treatment is a promising treatment option for patients with advanced HCC.

Keywords: hepatocellular carcinoma, atezolizumab, bevacizumab, TACE