Academy of Medical Sciences of I.R. Iran Archives of Iranian Medicine 1029-2977 28 10 2025 10 01 Efficacy and Safety Analysis of Triple Therapy (Pabolizumab+Cryoablation+Renvastinib) for Patients with Unresectable Hepatocellular Carcinoma (uHCC) 557 567 10.34172/aim.34630 EN Juan Lei https://orcid.org/0009-0009-3527-0995 Zhonghua Chen https://orcid.org/0009-0001-5790-9747 Journal Article 10.34172/aim.34630 2025 06 06 2025 08 26 Background: To determine whether employing a monoclonal antibody against programmed death receptor-1 (PD-1) improves the safety and effectiveness of cryoablation used with Renvastinib to treat unresectable hepatocellular carcinoma (uHCC). Methods: Our study retrospectively enrolled 232 uHCC patients who were treated at our medical center between January 2019 and December 2023. Propensity score matching (PSM) was employed in this study for 1:1 matching, and 86 patients were matched in each group. Following matching, the two groups’ negative events, and assessments were made on the objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). When comparing two groups, a group t test was employed to determine whether the quantitative data were normally distributed. The two groups’ survival rates were calculated using the Kaplan-Meier method, survival curves were made, and the log-rank test was performed to find differences between the two groups. Results: The median follow-up period was 28 months. Forty deaths (46.0%) happened in the double group, whereas 33 deaths (38.0%) occurred in the triple group. The ORR and DCR of the triple treatment group were significantly higher than those of the double therapy group (ORR: 35.6% vs. 14.5%, P=0.08; DCR: P=0.003; 86.1% vs. 64.1%). Compared to the double group, the OS and PFS rates in the triple group were considerably higher (P=0.045 and P=0.026, respectively). Analysis of univariate and multivariable Cox risk proportional models showed that AFP level (HR=2.37, P=0.001) and treatment regimen (HR=0.60, P=0.38) were independent risk factors for OS. Independent risk variables for PFS included diabetes mellitus (HR=1.94, P=0.05), prior local treatment (HR=0.63, P=0.014), treatment protocol (HR=0.65, P=0.025), and distant metastasis (HR=0.58, P=0.09). The incidence of negative reactions did not differ significantly between the two groups (P>0.05). Conclusion: Compared with cryoablation combined with renvatinib, cryoablation combined with renvatinib and PD-1 mAb significantly improved the efficacy and survival of patients with uHCC without increasing adverse events, giving unresectable liver cancer a clinical foundation for treatment optimization.