Both anti-angiogenesis and immunotherapy combined with interventional therapy in treatment of hepatocellular carcinoma: effect of hepatic artery infusion chemotherapy compared with hepatic artery chemoembolization

doi:10.16139/j.1007-9610.2022.02.013

Abstract

Abstract:

Objective To compare hepatic artery infusion chemotherapy (HAIC) with transcatheter arterial chemoembolization (TACE) in the treatment of hepatocellular carcinoma combined with both anti-angiogenesis and immunotherapy for effectiveness and safety. Methods Ninety-three patients with hepatocellular carcinoma including stage B 18 cases and stage C 75 cases, and 74 males, 19 females with a median age of 57 (27-78) in Tianjin Medical University Cancer Hospital from January 2019 to December 2020 were studied retrospectively. In the treatment combined with anti-angiogenesis and immunotherapy, 50 cases received TACE and 43 cases received HAIC. Response Evaluation Criteria in Solid Tumors (RECIST) Version 1.1 was used to evaluate the efficacy of treatment. The primary endpoints were both objective response rate (ORR) and disease control rate (DCR), and the secondary endpoints both median progression free survival (mPFS) and median overall survival (mOS). Results Both ORR (72.09% vs. 44.00%, P=0.006) and DCR (88.37% vs. 60.00%, P=0.002) were significantly more in HAIC group than in TACE group. The median follow-up duration was 12.13 months in HAIC group and 11.95 months in TACE group. mPFS in TACE group was 11.83 months (95%CI: 4.36-19.31 months) with mOS 17.93 months (95%CI: 11.80-24.06 months). Both mPFS and mOS did not reach in HAIC group. There were significant differences in PFS and OS between two groups (P=0.017; P=0.007). Conclusions The patients with advanced hepatocellular carcinoma would benefit from HAIC combined with both anti-angiogenesis and immunotherapy in disease control and survival with less side effects and better safety when compared with TACE combination treatment.

Key words: Hepatic artery infusion chemotherapy (HAIC), Hepatic transcatheter arterial chemoembolization (TACE), Anti-angiogenesis therapy, Immunotherapy, Hepatocellular carcinoma (HCC)

CLC Number:

R735.7

ZHANG Xihao, ZHANG Xinyun, CAO Manqing, ZHANG Jinliang, WANG Huaqi, ZHANG Su, FU Zhou, WANG Lu, ZHANG Ti. Both anti-angiogenesis and immunotherapy combined with interventional therapy in treatment of hepatocellular carcinoma: effect of hepatic artery infusion chemotherapy compared with hepatic artery chemoembolization[J]. Journal of Surgery Concepts & Practice, 2022, 27(02): 152-157.

Figures/Tables 4

References 18

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项目	HAIC联合组（n=43）	TACE联合组（n=50）	χ²	P值
年龄（岁）	59（27~78）	56（31~74）	0.456	0.501
性别			0.012	0.912
男	34（79.07）	40（80.00）
女	9（20.93）	10（20.00）
ECOG评分（分）			0.313	0.576
0	24（55.81）	25（50.00）
1	19（44.19）	25（50.00）
Child-Pugh分级			0.001	0.971
A级	36（83.72）	42（84.00）
B级	7（16.28）	8（16.00）
BCLC分期			3.059	0.080
B期	5（11.63）	13（26.00）
C期	38（88.37）	37（74.00）
甲胎蛋白≥400（μg/L）	25（58.14）	29（58.00）	0.000	0.989
门静脉癌栓	31（72.09）	27（54.00）	3.224	0.073
肝外转移	18（41.86）	15（30.00）	1.421	0.233
病毒感染			0.012	0.914
乙肝病毒	40（93.05）	49（98.00）
丙肝病毒	2（4.65）	3（6.00）
非病毒感染	1（2.33）	1（2）

项目	HAIC联合组（n=43）	TACE联合组（n=50）	χ²	P值
手术转化率	13（30.23）	7（14.00）	3.609	0.057
PR	31（72.09）	22（44.00）
SD	7（16.28）	8（16.00）
PD	5（11.63）	20（40.00）
ORR	31（72.09）	22（44.00）	7.444	0.006
DCR	38（88.37）	30（60.00）	9.468	0.002

项目	HAIC联合组（n=43）		TACE联合组（n=50）
项目	全部	3/4级	全部	3/4级
凝血功能障碍	26（60.47）	2（4.65）	29（58.00）	2（4.00）
AST升高	15（34.88）	0	16（32.00）	2（4.00）
ALT升高	14（32.56）	2（4.65）	11（22.00）	0
贫血	11（25.58）	1（2.33）	13（26.00）	1（2.00）
胆红素升高	10（23.26）	1（2.33）	13（26.00）	5（10.00）
皮疹	5（11.63）	0	9（18.00）	0
纳差	4（9.30）	0	9（18.00）	0
恶心、呕吐	3（6.98）	0	6（12.00）	0
体重减轻	1（2.33）	0	5（10.00）	0
消化道出血	2（4.65）	1（2.33）	5（10.0）	3（6.00）
高血压	5（11.63）	1（2.33）	4（8.00）	1（2.00）
甲状腺功能亢进	3（6.98）	0	1（2.00）	0
手足综合征	1（2.33）	0	1（2.00）	0
腹泻	2（4.65）	0	1（2.00）	0
牙龈出血	2（4.65）	0	1（2.00）	0
蛋白尿	1（2.33）	0	0	0