Transarterial chemoembolization combined with camrelizumab for recurrent hepatocellular carcinoma

Abstract

Purpose To evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with camrelizumab (hereafter, TACE-camrelizumab) in the treatment of patients with recurrent hepatocellular carcinoma (R-HCC) after curative resection. Patients and methods R-HCC patients who underwent TACE plus camrelizumab or TACE-alone from January 2016 to August 2021 were retrospectively evaluated. Patients were assessed for tumor response, progression-free survival, survival rates and adverse events. Results Seventy-one patients were included in this study, including 20 patients in the TACE- camrelizumab group and 51 patients in the TACE-alone group. The objective response rate was 56.9% in the TACE-alone group and 40% in the TACE-camrelizumab group at 3 months (P = 0.201). The disease control rates were 84.3% in TACE-alone group and 80% in TACE-camrelizumab group at 3 months (P = 0.663). The progression-free survival (PFS) of the TACE-alone group was slightly longer than those of the TACE- camrelizumab group (9 months vs. 6 months). However, there were no statistically significant differences in the median PFS (P = 0.586). Similarly, there were no significant differences in the half-year and one-year survival rates (P = 0.304, P = 0.430). Multivariate analysis revealed that Neutrophil-to-lymphocyte ratio (NLR) was associated with PFS significantly. 75% patients developed at least one type of AEs related to camrelizumab in TACE-camrelizumab group, and no patients developed severe AEs. Conclusion Comparing with TACE-Alone, the efficacy of TACE-camrelizumab for patients with R-HCC was similar. Meanwhile, the results of this study also indicated that TACE is still a better choice for patients with R-HCC.

Predicting Outcome in Combination Treatment of TACE and Camrelizumab for Advanced Hepatocellular carcinoma: Tumor Hypervascularity and Reactive Cutaneous Capillary Endothelial Proliferation

“…Previous studies have proved that TACE combined with carrelizumab has certain clinical efficacy in the treatment of advanced HCC. 20 , 21 In this study, the median TTP and OS of the whole cohort were 7.3 months and 14.3 months, respectively, which was better than previous studies using TACE or camrelizumab alone. 22–24…”

“…Previous studies have proved that TACE combined with carrelizumab has certain clinical efficacy in the treatment of advanced HCC. 20,21 In this study, the median TTP and OS of the whole cohort were 7.3 months and 14.3 months, respectively, which was better than previous studies using TACE or camrelizumab alone. [22][23][24] Subgroup analysis showed that for HCC patients with hypervascularity and RCCEP response, the median TTP and OS were 10.6 months and 19.3 months, respectively, which was superior to other groups of patients in the cohort study.…”

Heat-shock protein 90α is a potential prognostic and predictive biomarker in hepatocellular carcinoma: a large-scale and multicenter study

“…The combination of ICIs and targeted drugs has significantly improved the clinical outcomes of HCC patients [ 29 – 31 ]. In the same direction, the combination of TACE plus camrelizumab increased the PFS of advanced HCC patients to 9 months [ 5 ]. Nevertheless, predicting the efficacy of HCC patients receiving ICIs remains a clinical challenge with a definite positive outcome in the quality of patient care.…”

“…guidelines as the first-line treatment for advanced HCC, which could extend OS to 19.2 months [3,4]. Yusheng et al reported that the median progression-free survival (mPFS) of advanced HCC patients receiving transarterial chemoembolization (TACE) plus camrelizumab was 9 months [5]. In addition, in a randomized controlled study of operable HCC, patients who received adjuvant TACE had a higher threeyear OS rate compared to patients who underwent surgery alone (85.2% vs. 77.4%; p = 0.04) [6].…”

“…Recently, the combination of the anti-program death ligand 1(PD-L1) antibody, atezolizumab plus the anti-VEGF bevacizumab was approved by the Food and Drug Administration (FDA) and recommended by the National Comprehensive Cancer Network (NCCN) guidelines as the first-line treatment for advanced HCC, which could extend OS to 19.2 months [ 3 , 4 ]. Yusheng et al reported that the median progression-free survival (mPFS) of advanced HCC patients receiving transarterial chemoembolization (TACE) plus camrelizumab was 9 months [ 5 ]. In addition, in a randomized controlled study of operable HCC, patients who received adjuvant TACE had a higher three-year OS rate compared to patients who underwent surgery alone (85.2% vs. 77.4%; p = 0.04) [ 6 ].…”