The safety and efficacy of TACE combined with apatinib on patients with advanced hepatocellular carcinoma: a retrospective study

Abstract

As a novel vascular endothelial growth factor receptor-2 tyrosine kinase inhibitor (VEGFR2-TKI), apatinib has a certain anti-tumor effect for a variety of solid tumors. The present study evaluates its efficacy and safety in advanced hepatocellular carcinoma (HCC). In this study, 47 patients with advanced HCC were included. TACE monotherapy group included 22 patients that responded to TACE, while the group that received TACE and apatinib included 25 patients that progressed on TACE and were able to receive apatinib off label. Median overall survival (OS) was significantly improved in the apatinib plus TACE group compared with the TACE group. Similarly, apatinib in combination with TACE significantly prolonged median progression-free survival (PFS) compared with TACE monotherapy. Furthermore, there was a significant difference between combination therapy and monotherapy in both Barcelona clinic liver cancer (BCLC) B and BCLC C group. The combination therapy had a dramatic effect on OS and PFS for patients at both BCLC B and BCLC C level. The most common clinically adverse events of apatinib plus TACE group were fatigue, weight loss, hypertension, hand-foot syndrome and anorexia, which were manageable and tolerable. The efficacy analysis showed that there was no significant association of survival benefit with age, gender, Eastern Cooperative Oncology Group (ECOG) performance status, hypertension and hand-foot syndrome. Patients with macrovascular invasion and extrahepatic invasion showed worse survival benefits. In conclusion, apatinib combined with TACE revealed certain survival benefits for HCC patients who experienced progression following TACE, which can provide a promising strategy for HCC treatment.

Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors

“…On the other hand, the clinical study of sorafenib combined with TACE versus sorafenib alone in the treatment of progressive HCC showed that combination therapy can significantly improve tumor response rate and PFS, with reported median PFS of 5.2-5.4 months [6,16]. When treated with apatinib combined with TACE, several studies reported median PFS for advanced HCC of 4.5-9.5 months [10,19]. Our results showed a median PFS of up to 10 months.…”

“…In contrast, although the combination of apatinib with TACE was compared with TACE alone, the median OS of the combined treatment group was reported to be 11.9-22 months [17][18][19][20][21]. This study showed that the median OS of 51 patients with advanced HCC was 15 months, which is in accordance with the previous reports [9][10][11]. On the other hand, the clinical study of sorafenib combined with TACE versus sorafenib alone in the treatment of progressive HCC showed that combination therapy can significantly improve tumor response rate and PFS, with reported median PFS of 5.2-5.4 months [6,16].…”

“…Alternatively, several previous studies evaluated possible factors affecting survival but yielded conflicting results. Yang et al [22] used apatinib combined with TACE to treat advanced HCC and found that patient survival was not associated with any apatinib-related adverse events but with macrovascular invasion and extrahepatic metastases. In contrast, Liao et al [23] treated stage IV sarcoma with apatinib and found that post-treatment hypertension, hand-foot syndrome, and proteinuria indicated a favorable prognosis.…”

“…After inclusion, 11 patients received 1 TACE session, 10 received 2 sessions, and 30 received 3 or more sessions. The median number of TACE treatments per patient was 3.6 ± 2.8 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Efficacy and safety of stereotactic body radiation therapy combined with transarterial chemoembolization for Chinese intermediate-to advanced-stage hepatocellular carcinoma patients: a systematic review and meta-analysis

“…However, the limited indications and contraindications restrict the clinical use of the monotherapy which may lead to a high recurrence rate. In recent years, researchers have tried relevant clinical trials to seek the treatment effect of combined treatment on patients with intermediate-and advanced-stage HCC [7][8][9][10] .…”