TACE Combined with PD-L1 Inhibitors Effectively Mitigates TACE Resistance in Advanced Hepatocellular Carcinoma: A Propensity Score-Matched Study

Transarterial chemoembolization (TACE) combined with PD-(L)1 inhibitors and molecular targeted therapies (MTT) has demonstrated significant improvements in progression-free survival (PFS), overall survival (OS).This retrospective study investigated TACE-PD-(L)1-MTT combination therapy's role in preventing TACE resistance in advanced HCC. Among 604 eligible patients (532 TACE alone vs. 72 combination) after propensity score matching, TACE resistance occurrence was evaluated post-3 treatment cycles. Combination therapy significantly reduced resistance incidence (9.7% vs. 38.8%, p < 0.001) and demonstrated superior efficacy in inhibiting tumor progression compared to TACE monotherapy. These findings support the preventive potential of triple combination therapy against TACE resistance while improving clinical outcomes in advanced HCC .