Abstract: Objective The aim of this study was to investigate efficacy of local transhepatic arterial chemoembolization (TACE) with combination of immune and targeted therapy in the treatment of patients with advanced primary liver cancer(aPLC). Methods 86 patients with aPLC were encountered in Department of Hepatobiliary Surgery, Xiangxi Autonomous Prefecture People's Hospital affiliated to Jishou University between January 2021 and January 2025, and assigned to undergo TACE in 42 cases in the control, or to receive TACE with combination of lenvatinib and tislelizumab treatment in another 44 cases in the observation for three months. Serum alpha-fetoprotein (AFP) and abnormal prothrombin-II (PIVKA-II) levels were detected routinely, and peripheral blood lymphocyte subsets were determined by FCM. Results By end of three-month treatment, the disease control rate was 70.5% and the objective remission rate was 36.4% in the observation group, both much higher than 47.6% and 16.7% (P＜0.05) in the control group; serum AFP and PIVKA-Ⅱ levels were (653.5±131.5)ng/mL and (864.5±89.6)ng/mL, both much lower than [(965.5±152.2)ng/mL and (1038.4±91.3)ng/mL, respectively, P＜0.05] in the control; percentage of peripheral blood CD⁺₄ cells and CD⁺₄/CD⁺₈ cell ratio were (33.6±3.1) % and (1.2±0.3), both significantly higher than [(29.5±2.7 %) and (0.9±0.2), respectively, P＜0.05] in the control; after treatment, the successful conversion surgery rate in the observation group was 22.7%, not significantly different as compared to 7.1% (P>0.05) in the control group. Conclusion Local TACE in combination with immune and targeted therapy in dealing with patients with aPLC is short-termly efficacious, which might alleviate immune suppression with control of tumor progression.

Key words: Hepatoma, Transhepatic arterial chemoembolization, Lenvatinib, Tislelizumab, Therapy