Effect of bevacizumab administered prior to transarterial chemoembolization on the therapeutic effects of lenvatinib given post-TACE in primary liver cancer patients

Objective: To determine the therapeutic effects of lenvatinib combined with bevacizumab following transarterial chemoembolization (TACE) in patients with primary liver cancer. Materials and methods: 100 patients with primary liver cancer were recruited in the period from January 2020 to January 2021 and allocated with randomization into a control group (n = 50) and a test (bevacizumab) group (n = 50). The patients in the control group received lenvatinib for 4 weeks following TACE, whereas those in the test group received bevacizumab for 6 weeks prior to TACE and subsequent therapy with lenvatinib for 4 weeks. The serum concentration of interferon-. (INF-.), interleukin-10 (IL-10), soluble interleukin-2 receptor (sIL-2R), interleukin-12 (IL-12), superoxide dismutase (SOD), total antioxidant capacity (TAOC), glutathione (GSH), malondialdehyde (MDA), total bilirubin (TBil), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), carbohydrate antigen 242 (CA242), CA724, a-fetoprotein (AFP) and carcinoembryonic antigen (CEA) were determined in both groups at the commencement of treatment in January 2020 and 12 months later and compared with the observed therapeutic effects. Results: The concentrations of CA242, CEA, CA724, and AFP in the bevacizumab group were lower than those in the control group (p < 0.05). The concentration of IL-12 and INF-. in the bevacizumab group were higher, but the levels of IL-10 and sIL2R lower than in the control group (p < 0.05). In the bevacizumab group, the level of MDA was lower, whereas the levels of TAOC, SOD, and GSH were higher than those in the control group (p < 0.05). The bevacizumab group also had lower levels of ALT, TBil, and AST and a higher level of ALP than control group (p < 0.05). The response rate based on tumor status (size, progression) in the bevacizumab group was higher than in the control group (p < 0.05). Conclusion: The therapeutic effects of lenvatinib following TACE in primary liver cancer are significantly greater when combined with bevacizumab administered for 6 weeks prior to TACE.