{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:46:06Z","timestamp":1782708366190,"version":"3.54.5"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T00:00:00Z","timestamp":1782691200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transarterial chemoembolization (TACE) is an established treatment for intermediate to advanced hepatocellular carcinoma (HCC) in China, where chronic hepatitis B virus (HBV) infection constitutes the primary etiology. Although the use of TACE combined with atezolizumab\/bevacizumab (TACE+TA) is increasing, robust evidence regarding its efficacy and safety\u2014including the risk of HBV reactivation\u2014remains limited in this etiologically distinct population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective analysis included 246 patients with HBV-related HCC treated between 2020 and 2024. Patients were stratified according to the treatment received: TACE monotherapy (n = 113) or TACE+TA (n = 133). The primary endpoints were overall survival (OS) and progression-free survival (PFS). Tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST). To minimize selection bias, a 1:1 propensity score matching (PSM) analysis was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After matching, patients receiving TACE+TA achieved superior outcomes compared with TACE monotherapy, with prolonged median OS (19 vs. 13 months;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001) and extended median PFS (8 vs. 6 months;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.004). In the unmatched cohort, the objective response rate was also higher in the combination group (48.1% vs. 30.0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.004). Independent risk factors for worse OS included elevated baseline HBV-DNA load, advanced BCLC stage, and receipt of monotherapy. Notably, the combination therapy group experienced a higher incidence of adverse events, particularly HBV reactivation (8.3% vs. 1.8%;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.023), immune-mediated hepatitis, pneumonitis, and thrombocytopenia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In patients with HBV-related HCC, TACE+TA confers a significant survival advantage over TACE monotherapy, albeit with an increased risk of HBV reactivation and immune-related adverse events. This finding underscores the need for rigorous antiviral prophylaxis and close monitoring in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1840779","type":"journal-article","created":{"date-parts":[[2026,6,29]],"date-time":"2026-06-29T04:26:52Z","timestamp":1782707212000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and safety of combining TACE with atezolizumab\/bevacizumab versus TACE alone: a retrospective propensity score-matched cohort study in HBV-related hepatocellular carcinoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Jie","family":"Feng","sequence":"first","affiliation":[{"name":"Department of Radiology, The Second People's Hospital of China Three Gorges University","place":["Yichang, Hubei, 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