ArticleFrontiers in immunology2026
Efficacy and safety of TACE combined with MWA followed by immune checkpoint inhibitors and anti-VEGF/tyrosine kinase inhibitors in hepatocellular carcinoma beyond the up-to-7.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Previous studies have shown that locoregional therapy combined with systemic treatment provides survival benefits with manageable safety in patients with intermediate-to-advanced large hepatocellular carcinoma (HCC). However, the optimal treatment strategy for HCC beyond the up-to-7 criteria remains unclear because of the high tumor burden and recurrence risk. This study aimed to evaluate the efficacy and safety of transarterial chemoembolization (TACE) plus microwave ablation (MWA) followed by targeted immunotherapy in patients with HCC beyond the up-to-7 criteria. Methods: This single-center retrospective study included patients with HCC beyond the up-to-7 criteria treated at our institution between October 2018 and December 2023. The study group received TACE plus MWA followed by ICIs combined with anti-VEGF/TKI therapy, while the control group received TACE followed by ICIs combined with anti-VEGF/TKI therapy. The primary endpoint was progression-free survival (PFS) assessed by mRECIST, and the secondary endpoints were overall survival (OS) and treatment-related adverse events (TRAEs).Baseline data were balanced using a one-to-one propensity score matching (PSM) and inverse probability of treatment weighting (IPTW). Result: Among the 80 included patients, the median follow-up time was 68.4 months. Thirty patients had hepatitis B and 40 had hepatitis C. Patients were classified as BCLC stage A-C, with a median tumor size of 7.1 cm. The control and study groups included 41 and 39 patients, respectively. The median PFS was 5.7 months(95%CI:3.617-7.716) versus 11.4 months(95%CI:8.741-14.125), and the median OS was 16.5 months(95%CI:10.863-22.071) versus 40.2 months (95%CI:34.302-46.165), respectively (both Conclusion: TACE combined with MWA followed by immune checkpoint inhibitors and anti-VEGF/TKI therapy prolonged progression-free and overall survival in patients with HCC beyond the up-to-7 criteria, with manageable safety.
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