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Triple therapy with TACE, TKIs, and ICIs shows survival benefits in unresectable hepatocellular carcinomaTriple therapy offers a 52% chance of living three years with advanced liver cancer

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Key Takeaway
Note that triple therapy yields specific survival metrics in unresectable HCC, though patient selection remains unclear.

This retrospective cohort study analyzed data from 270 patients with unresectable hepatocellular carcinoma treated at 20 multicenter sites. The intervention involved a combination of transarterial chemoembolization (TACE), tyrosine kinase inhibitors (TKIs), and immune checkpoint inhibitors (ICIs) as first-line therapy. No comparator group was reported in this analysis.

Efficacy outcomes included an objective response rate of 47.9% and a disease control rate of 63.2%. Median progression-free survival was 15.9 months. At three years, overall survival was 52.2% and progression-free survival was 30.7%. Specific p-values or confidence intervals were not reported for these results.

Safety was evaluated using treatment-related adverse events (TRAEs) according to NCI-CTCAE v5.0. Rates of serious adverse events, discontinuations, and overall tolerability were not reported. The study did not specify which patient subpopulations derived the most benefit.

A key limitation is that the specific patient population that would benefit most from this regimen remains unclear. Additionally, follow-up duration was not reported. While these results offer prognostic insights, the retrospective nature and lack of a control group limit causal inference. Future work should aim to develop a practical prognostic scoring model to identify those with the best beneficial outcomes.

For people with unresectable hepatocellular carcinoma, also known as advanced liver cancer that cannot be removed by surgery, finding effective treatments is a daily struggle. A new look at 270 patients across 20 centers shows that a combination of TACE, tyrosine kinase inhibitors, and immune checkpoint inhibitors might be a powerful option. This approach helped nearly half of the patients achieve a response to the treatment, and more than 60% saw their disease stop growing or shrink.

The most encouraging news is the survival data. About 52% of these patients were still alive three years after starting this triple therapy. They also lived a median of 15.9 months without the cancer getting worse before it did. These results suggest that stacking these three different types of treatment could work better than using just one or two on its own.

However, the study has some important gaps. The researchers could not say exactly which specific patients would benefit most from this complex regimen. Because the data comes from looking back at past records, we do not know if the results would hold true for everyone. Until we have more information, doctors must carefully weigh the potential benefits against the risks for each individual patient.

What this means for you:
Triple therapy may offer a 52% chance of three-year survival for advanced liver cancer patients.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Background and aimsTranscatheter chemoembolization (TACE) combined with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) shows promising efficacy in treating unresectable hepatocellular carcinoma (uHCC), but the specific patient population that would benefit most from this regimen remains unclear. This study aims to evaluate the prognoses of uHCC patients receiving triple therapy and develop a practical prognostic scoring model to identify those with the best beneficial.MethodsThis multicenter retrospective study enrolled 270 uHCC patients who received first-line triple therapy across 20 centers. These participants were divided into the training (n=190) and external validation (n=80) cohorts. Treatment response was assessed by the modified Response Evaluation Criteria in Solid Tumors (mRECIST), and safety was evaluated via treatment-related adverse events (TRAEs) using National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0 (NCI-CTCAE v5.0). Cox proportional hazards regression was used to identify independent prognostic factors for overall survival, which were utilized to develop the SAGES score; Kaplan-Meier curves and area under the receiver operating characteristic curve (AUC) were employed to validate the model’s performance.ResultsIn the training cohort, the objective response rate was 47.9% and disease control rate was 63.2%. The median progression-free survival was 15.9 months, with 3-year overall survival and progression-free survival rates of 52.2% and 30.7%, respectively. Independent prognostic factors for poor overall survival included albumin-bilirubin grade 2–3, alpha-fetoprotein ≥400 ng/mL, maximum tumor size ≥8 cm, presence of extrahepatic metastasis, and absence of conversion surgery. Integrating these five factors, the SAGES score effectively stratified patients into low- (0–3 points), intermediate- (4–7 points), and high-risk (8–10 points) groups with significantly divergent survival outcomes in both cohorts (all p
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