SYSTEMATIC REVIEW article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1640970
Hepatic Arterial Infusion Chemotherapy Versus Systemic Chemotherapy for Advanced Intrahepatic Cholangiocarcinoma: A Meta-Analysis of Survival Outcomes
Provisionally accepted
- West China Hospital, Sichuan University, Chengdu, China
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Background: Intrahepatic cholangiocarcinoma (iCC) is an aggressive hepatobiliary malignancy with limited therapeutic options and poor survival outcomes. Hepatic arterial infusion chemotherapy (HAIC) has emerged as a promising treatment alternative to systemic chemotherapy, but its clinical benefits require comprehensive evaluation.Methods: A systematic review and meta-analysis were conducted, including 10 studies with 1,493 patients. Data on overall survival (OS), progression-free survival (PFS), and key prognostic factors were extracted. Pooled hazard ratios (HR) were calculated using a random-effects model.Results: HAIC significantly improved OS (HR = 0.51, p < 0.001) and PFS (HR = 0.58, p < 0.001) compared to systemic chemotherapy. Subgroup analyses revealed consistent benefits across various patient characteristics, including age, tumor stage, and baseline liver function. Patients with lower tumor burden (HR = 0.45) and ECOG performance status ≤1 (HR = 0.50) derived the greatest benefit. Additionally, patients with CA 19-9 levels <1,000 U/mL showed significantly improved OS (HR = 0.48). Conclusion: HAIC prolongs survival and improves disease control in advanced iCC patients compared to systemic chemotherapy. These findings support the adoption of HAIC as a valuable treatment strategy for selected patients, particularly those with lower tumor burden and favorable performance status.
Keywords: Intrahepatic cholangiocarcinoma (ICC), Hepatic arterial infusion chemotherapy (HAIC), Survival outcomes, Meta-analysis, prognostic factors (PF)
Received: 04 Jun 2025; Accepted: 24 Jun 2025.
Copyright: © 2025 Cheng, Zeng, Liu, lu and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Bei Li, West China Hospital, Sichuan University, Chengdu, China
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