ORIGINAL RESEARCH article
Front. Immunol.
Sec. Cancer Immunity and Immunotherapy
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1643082
This article is part of the Research TopicImmuno-metabolic Approaches for the Treatment of Hepatobiliary and Pancreatic TumorsView all 6 articles
Hepatic arterial interventional therapies alone or in combination with molecular targeted therapies and PD-(L)1 inhibitors in locally aggressive, early recurrent hepatocellular carcinoma: a retrospective study
Provisionally accepted
Weixin Luo
Lixuan LiuWenping Lin
Jie Mei
Yan-Song LinZhoutian YangFangyi LiuWei Wei*
Rongping Guo*Jingping Yun*- Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
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Background: Current treatment strategies for locally aggressive (beyond Milan criteria), early recurrent hepatocellular carcinoma (erHCC) lack consensus. This study aims to compare the efficacy of hepatic arterial interventional therapies (HAIT) combined with molecular targeted therapies and PD-(L)1 inhibitors (HAIT-M-P) versus HAIT alone for locally aggressive erHCC. Methods: This study retrospectively reviewed the data of locally aggressive erHCC patients treated with HAIT alone or HAIT-M-P at Sun Yat-sen University Cancer Center from 2020 to 2024. The progression-free survival (PFS), overall survival (OS), tumor responses, and treatment-related adverse events (TRAEs) were compared. Propensity score matching (PSM) and multivariate Cox regression model were used to minimize confounding bias. Results: A total of 101 patients with locally aggressive erHCC were enrolled. Compared with the HAIT group (n=51), the HAIT-M-P group (n=50) demonstrated significantly longer median PFS (10.1 months vs. 3.7 months, HR = 0.36, P < 0.001) and comparable median OS (not reached vs. 38.2 months, HR = 0.45, P = 0.065). After PSM, 24 pairs of patients were included. The HAIT-M-P group maintained a significant median PFS advantage (12.8 months vs. 3.7 months, HR = 0.28, P < 0.001) and comparable median OS (not reached vs. 38.2 months, HR = 0.56, P = 0.330). In the multivariate Cox regression analysis, the HAIT-M-P group demonstrated a significant improvement in OS (HR = 0.30, P = 0.033). The objective response rate and disease control rate were significantly higher in the HAIT-M-P group than in the HAIT group, respectively, according to the RECIST v1.1 (30.0% vs. 7.8%, P = 0.009; 82.0% vs. 54.9%, P = 0.007) and mRECIST criteria (56.0% vs. 19.6%, P < 0.001; 90.0% vs. 58.8%, P = 0.001). The grade 3–4 TRAEs between the two groups were comparable (19.6% vs. 34.0%, P = 0.159). Conclusion: Compared with HAIT alone, HAIT-M-P was associated with improved PFS and tumor response rates, and showed a possible trend toward improved OS in patients with locally aggressive erHCC, which warrants further validation.
Keywords: Hepatocellular Carcinoma, early recurrence, Milan criteria, Immune checkpoint inhibitor, Hepatic arterial interventional therapy, Molecular Targeted Therapy
Received: 07 Jun 2025; Accepted: 19 Aug 2025.
Copyright: © 2025 Luo, Liu, Lin, Mei, Lin, Yang, Liu, Wei, Guo and Yun. 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:
Wei Wei, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
Rongping Guo, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
Jingping Yun, Sun Yat-sen University Cancer Center (SYSUCC), Guangzhou, China
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