IDDF2024-ABS-0235 Combining loco-regional therapy and sorafenib in hepatocellular carcinoma: a retrospective comparative study

<h3>Background</h3> Recent advances in systemic therapeutic options have significantly improved survival outcomes in patients with advanced hepatocellular carcinoma (HCC). However, optimizing treatment strategies across different disease stages remains a challenge. Combining loco-regional treatments with systemic therapies has gained interest as a potential approach to enhance patient outcomes. In this study, we investigated the efficacy and safety of combining locoregional therapy (transarterial chemoembolization [TACE] or radioembolization [TARE]) with sorafenib in a cohort of Saudi Arabian patients. <h3>Methods</h3> We conducted a retrospective analysis of data from 60 HCC patients treated at a tertiary hospital, King Abdullah Medical City, Makkah. Among them, 43 patients received locoregional therapy (LRT) alone (TACE or TARE), while 17 patients were treated with a combination of locoregional therapy and sorafenib (LRTS). Demographic characteristics, BCLC (Barcelona Clinic Liver Cancer) class distribution, treatment response rates, HCC progression, and adverse events were compared between the two groups. <h3>Results</h3> The LRT group had a slightly higher mean age (72 years) compared to the LRTS group (68 years), with more pronounced male predominance (88% vs. 81%, respectively). BCLC Stage A and B patients were more prevalent in the LRTS group than in the LRT group (59% vs 42% and 30% and 18%, respectively). The rates of complete response, partial response, and stable disease between LRT and LRTS were 30% vs. 18% (p = 0.32), 30% vs. 42% (p = 0.61) and 19% vs. 12% (p = 0.79). The HCC progression rate was 21% for LRT and 29% for LRTS (p = 0.72). The two-year survival rate was 9% for LRT and 6% for LRTS (p = 0.93). Adverse events were similar between techniques and included liver decompensation, a rise in transaminase, and abdominal pain. <h3>Conclusions</h3> Combining loco-regional therapy with sorafenib appears to be a promising approach in the management of HCC. Further prospective studies are warranted to validate these findings and refine treatment algorithms for this challenging malignancy.