Ablation of Oligometastasis Combined With Lenvatinib and PD-1 Inhibitor for Advanced Hepatocellular Carcinoma

Prior treatment

• advanced HCC Lenvatinib and PD-1 inhibitor treated with as second systemic therapy;

Age

• age \< 18 years or \> 75 years;

Other

• recurrent HCC;
• advanced HCC with more than five metastases;
• no response to Lenvatinib;
• metastases size \> 5 cm;
• life expectancy less than 3 months.

• diagnosis of primary HCC, confirmed histologically or clinically according to the criteria of the American Association for the Study of Liver Diseases 20;
• presence of oligometastasis, the metastases found within three month of HCC diagnosis;
• metastases with limited five sites and no more two organs involved, with a maximum diameter of ≤5cm;
• receipt of Lenvatinib and PD-1 inhibitor as the first-line systemic therapy for a minimum of 3 months before study ablation, with controlled intrahepatic tumors and no progression of metastases. Controlled intrahepatic tumors were defined as those showing a partial or stable response according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST);
• undergone locoregional treatments, including transarterial artery chemoembolization (TACE) or hepatic arterial infusion chemotherapy (HAIC);
• classified as Child-Pugh class A or B and having an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1;
• no history of other malignancies.
• life expectancy more than 3 months;
• agreed to participated in this clinical trial;
• Hemameba ≥3.0 x109/L, neutrophil ≥1.5x109/L, hemoglobin≥10.0 g/L, platelet≥100x 109/L, ALT; AST; bilirubin ≤1.5-fold normal, GFR≥60ml/min.