Efficacy and safety of camrelizumab plus transarterial chemoembolization in intermediate to advanced hepatocellular carcinoma patients: A prospective, multi-center, real-world study

Abstract

ObjectiveCamrelizumab is a newly developed program-death receptor one inhibitor; the real-world evidence about its application in hepatocellular carcinoma (HCC) treatment is lacking. Therefore, this prospective, multi-center, real-world study evaluated the efficacy and safety of camrelizumab plus transarterial chemoembolization (TACE) in treating intermediate-to-advanced HCC patients.MethodsThis study consecutively enrolled 101 intermediate to advanced HCC patients. All patients received camrelizumab-based treatment within 30 days of the perioperative period of the TACE operation. The primary outcome was progression-free survival (PFS), and the secondary effects were overall survival (OS), objective response rate (ORR), disease control rate (DCR), and AEs.ResultsSpecifically, the median PFS was 9.7 (95% confidence interval: 7.4–12.0) months, with a 1-year PFS rate of 30.6%. Meanwhile, the median OS was not reached (NR) yet, with a 1-year OS rate of 61.9%. Besides, the CR, PR, SD, and PD rates were 12.8%, 44.9%, 29.5%, and 12.8%, respectively. The ORR and DCR were 57.7% and 87.2%, respectively. More cycles of camrelizumab were independently correlated with prolonged PFS (hazard ratio (HR): 0.415, P = 0.002), whereas longer intervals between camrelizumab administration and TACE were independently associated with unfavorable PFS (HR: 1.873, P = 0.032). The incidence of total AEs was 90.1%; most AEs were grade 1 (20.8%), grade 2 (28.7%) and grade 3 (37.6%), while only 3 (3.0%) patients had grade 4 AEs.ConclusionThe camrelizumab plus TACE regimen is effective and safe, indicating its potential to serve as a promising treatment choice for intermediate to advanced HCC patients.

Transarterial chemoembolization combined with molecularly targeted agents plus immune checkpoint inhibitors for unresectable hepatocellular carcinoma: a retrospective cohort study

“…The systemic agent-attributed AEs observed in this study were relatively common in previous studies ( 26 , 27 ), and no grade 4 AEs or treatment-related death occurred in the two groups. The most common AEs that occurred in this study included hypertension, skin rash, proteinuria, and reactive cutaneous capillary endothelial proliferation (RCCEP), which were also similar to those in previous research.…”

Integrating the new systemic treatment landscape and surgical therapy in hepatocellular carcinoma

“…The combination interestingly provided higher response rates even outside the ablated zone supporting the notion that systemic treatment may augment locoregional strategies and vice versa. Further studies built on this premise and demonstrated that TACE + anti-PD1 may provide a survival benefit to either standalone treatment in intermediate and advanced stage, respectively (56,57). Similar results have been reported for transarterial radioembolization (TARE) which was able to elicit a response rate of 30.6% when combined with nivolumab compared to 20% as monotherapy (58).…”

Transcatheter arterial chemoembolization plus apatinib with or without camrelizumab for unresectable hepatocellular carcinoma: a multicenter retrospective cohort study

“…Besides, Guo et al found that 75% of patients in the TACE plus camrelizumab group had at least one AE associated with camrelizumab, and no patient developed serious AE [ 35 ]. The total incidence of AE in a prospective study with TACE and camrelizumab was 90.1%, and most of them were grade 1–3 [ 36 ]. In our study, the rates of immunotherapy-related AE (such as RCCEP) were also comparable to those seen in the Ju study's AC or TACE + AC cohort.…”