tislelizumab + lenvatinib

The combination of tislelizumab and lenvatinib is a dual-therapy approach used primarily for treating hepatocellular carcinoma (HCC). This combination brings together two distinct mechanisms of action to create a potentially more effective treatment option. Tislelizumab is a monoclonal antibody that targets PD-1 (programmed death-1), an immune checkpoint protein. By binding to PD-1, tislelizumab restores T-cell function and revitalizes immune responses against tumor cells. It features an engineered Fc fragment that minimizes binding to FcγR on macrophages, which may help reduce antibody-dependent phagocytosis as a potential mechanism of treatment resistance. Lenvatinib is a receptor tyrosine kinase (RTK) inhibitor that targets multiple pathways involved in tumor angiogenesis and progression. It inhibits vascular endothelial growth factor receptors (VEGFR1, VEGFR2, VEGFR3), fibroblast growth factor receptors (FGFR1-4), platelet-derived growth factor receptor alpha (PDGFRα), KIT, and RET. This multi-targeted approach helps block blood vessel formation and other processes essential for tumor growth. Clinical trials have shown promising results for this combination. In a phase 2 study of tislelizumab plus lenvatinib as first-line therapy for unresectable HCC, the combination demonstrated significant antitumor activity with favorable tolerability. After a median follow-up of 15.7 months, the confirmed objective response rate was 38.7%, and the disease control rate was 90.3%. The median progression-free survival was 8.2 months, and the overall survival rate at 12 months was 88.6%. The combination has also been studied in other contexts, including as neoadjuvant therapy for recurrent HCC and in combination with transarterial chemoembolization (TACE) for intermediate-stage HCC. Recent real-world data from 2025 has further supported the efficacy of this combination, particularly in patients who experienced lenvatinib treatment failure. The safety profile of tislelizumab plus lenvatinib appears manageable, with grade ≥3 treatment-related adverse events occurring in approximately 28.1% of patients in one study. Common adverse events include fatigue, hypertension, and reduced appetite. This combination represents an important advancement in the treatment landscape for HCC and potentially other solid tumors, offering improved outcomes compared to monotherapy approaches.

Brand names

TeventriLenvimaBaizean

Other names

tislelizumab plus lenvatinibTL combination