Researchers studied 190 patients with initially unresectable hepatocellular carcinoma (uHCC) who received a triple combination: transarterial chemoembolization (TACE), lenvatinib, and a PD-1 inhibitor. They compared outcomes between HBV-positive and HBV-negative patients using a statistical method to balance the groups (propensity score matching), leaving 30 matched pairs for key analyses.
HBV-positive patients had higher rates of surgical conversion (20% vs. 10% after matching), better tumor responses, and longer survival. Median overall survival was not reached in the HBV-positive group versus 20.0 months in the HBV-negative group. Progression-free survival was 28.4 months versus 17.3 months. However, a landmark analysis for progression-free survival was not statistically significant, suggesting the timing of benefit may vary.
Safety was similar: Grade 3–4 adverse events were comparable, and no treatment-related deaths were reported. Discontinuation rates were not provided.
This was a small, single-center, retrospective study, so the results show an association rather than proof of cause. The findings need confirmation in larger, prospective trials before changing care.