Hepatic arterial infusion chemotherapy combined with apatinib and carizolizumab for hepatocellular carcinoma with major portal vein tumor thrombosis:analysis of its safety and efficacy
10.3969/j.issn.1008-794X.2025.09.017
- VernacularTitle:经肝动脉灌注化疗联合阿帕替尼及卡瑞利珠单抗治疗合并门静脉主干癌栓肝细胞癌安全性和有效性分析
- Author:
Shugui HUANG
1
;
Qiming WEI
;
Fengtao ZHANG
Author Information
1. 510080 广东广州 广东药科大学附属第一医院普外一科
- Keywords:
hepatic arterial infusion chemotherapy;
apatinib,camrelizumab;
hepatocellular carcinoma;
major portal vein tumor thrombosis;
propensity score matching
- From:
Journal of Interventional Radiology
2025;34(9):1002-1009
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the safety and efficacy of hepatic arterial infusion chemotherapy(HAIC)combined with apatinib and carizolizumab in the treatment of hepatocellular carcinoma(HCC)with major portal vein tumor thrombosis(Vp4).Methods The clinical data of patients with HCC complicated by Vp4 from three certain Grade Ⅲ medical centers,who received HAIC combined with apatinib and carizolizumab(triple treatment group)or received HAIC alone(simple HAIC group)from July 2018 to December 2023,were retrospectively collected.Propensity score matching(PSM)was used to balance the general differences between groups,and the pre-PSM and post-PSM overall survival time(OS),progression-free survival time(PFS),and tumor response rate were compared between the two groups.Based on COX proportional hazards regression model the survival-related risk factors were identified.The clinical safety was evaluated by comparing the incidence of adverse reactions between different therapeutic regimens.Results In the overall cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which in the simple HAIC group were 6.9 months and 4.2 months respectively(both P＜0.001).In the triple treatment group and the simple HAIC group,the objective response rate(ORR)was 41.2％and 15.2％respectively(P＜0.001),and the disease control rate(DCR)was 77.9％and 68.5％respectively(P=0.185).In the PSM cohort,the median OS and median PFS in the triple treatment group were 16.4 months and 9.1 months respectively,which were significantly longer than 7.4 months and 3.7 months respectively in the simple HAIC group.In the triple treatment group and the simple HAIC group,the ORR was 39.5％and 11.6％respectively(P=0.003),and the DCR was 81.4％and 62.8％respectively(P=0.054).Univariate and multivariate analyses showed that HAIC combined with apatinib and carizolizumab treatment was an independent factor influencing both OS and PFS.No statistically significant difference in the incidence of adverse reactions of all levels existed between the two groups,although the incidence of some adverse reactions in triple therapy group was higher than that in the simple HAIC group.Conclusion Compared with pure HAIC therapy,HAIC combined with apatinib and carizolizumab has better survival benefits and tumor response rate,it is clinically safe and effective,besides,the patients can well tolerate this treatment.Therefore,HAIC combined with apatinib and carizolizumab is a promising treatment option for patients with HCC complicated by Vp4.
