Hepatic arterial infusion chemotherapy combined with systemic therapy sequentially or simultaneously for advanced hepatocellular carcinoma

• Published in: Cancer immunology, immunotherapy immunotherapy, 2024-11, Vol.74 (1), p.24-12, Article 24
• Main Authors: Cao, Yu-zhe, Pan, Jia-yu, Zheng, Guang-lei, An, Chao, Zuo, Meng-Xuan
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer Research; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Chemotherapy; Female; Hepatic arterial infusion chemotherapy; Hepatic Artery; Hepatocellular carcinoma; Humans; Immune Checkpoint Inhibitors - administration & dosage; Immune Checkpoint Inhibitors - therapeutic use; Immunology; Infusions, Intra-Arterial; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Medical prognosis; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Patients; PD-(L)1 blockade; Retrospective Studies; Sequentially and simultaneously; Survival; Targeted therapy
• ISSN: 1432-0851; 0340-7004; 1432-0851
• DOI: 10.1007/s00262-024-03872-6

Background and aims The goal of this study was to compare the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with targeted therapy and PD-(L)1 blockade (triple therapy), either sequentially (SE) or simultaneously (SI), in the treatment of Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC). Approach and results From January 1, 2018, to June 1, 2022, 575 patients with BCLC stage C HCC who underwent SE or SI triple therapy were retrospectively enrolled. Propensity score matching (PSM; 1:1) was performed to eliminate possible confounder imbalances across cohorts. We used the Kaplan–Meier method and a log-rank test to compare the overall survival (OS) and progression-free survival (PFS) rates between the SI and SE groups. The tumor response and the incidence of adverse events (AEs) were reported. After PSM, 182 patients in each of the two groups were matched. The median OS in the SI group was significantly longer than that in the SE group (28.8 vs. 16.1 months; P  = 0.002), and the median PFS was significantly improved in the SI versus SE group (9.6 vs. 7.0 months; P  = 0.01). The objective response rate based on the mRECIST was higher in the SI group (58% vs. 37%; P