ORIGINAL RESEARCH article
Front. Oncol.
Sec. Gastrointestinal Cancers: Hepato Pancreatic Biliary Cancers
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1615506
This article is part of the Research TopicReviews in Gastrointestinal and Hepatic Pharmacology: 2024View all 13 articles
Efficacy and safety of TACE-HAIC combined with tyrosine kinase inhibitors and immune checkpoint inhibitors for the patients with BCLC-defined stage B-C HCC
Provisionally accepted- Harbin Medical University Cancer Hospital, Harbin, China
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Background To evaluate the therapeutic efficacy and safety profile of combining transarterial chemoembolization (TACE) with hepatic arterial infusion chemotherapy (HAIC) combined with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in patients with hepatocellular carcinoma (HCC) classified as Barcelona Clinic Liver Cancer (BCLC) stage B or C. Methods This single-center retrospective analysis included patients with intermediate-to-advanced HCC diagnosed and treated between January 2020 and December 2023. Of 197 eligible patients meeting inclusion criteria, 103 were allocated to the TACE+HAIC+TKI+ICI (T+H+T+I) group and 94 to the HAIC+TKI+ICI (H+T+I) group. Propensity score matching (PSM) was employed to minimize confounding bias, yielding 50 patients per group in the final matched cohorts. Comparative analyses assessed overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR). Primary endpoints were OS and PFS; secondary endpoints included ORR and safety outcomes.Result Among the 100 patients included in the analysis, 50 patients received T+H+T+I therapy while the remaining 50 underwent H+T+I treatment, with median follow-up durations of 13.1 months and 14.3 months, respectively. After PSM, the baseline characteristics showed no significant differences between the two groups. The T+H+T+I group demonstrated superior median overall survival (mOS) ] vs 14.23 months [95% CI: 12.23-16.24]; P=0.019) and longer median progression-free survival (mPFS) .02] vs 10.60 months [95% CI: 7.71-13.49]; P<0.001) as assessed by modified Response Evaluation Criteria in Solid Tumors (mRECIST) version 1.1. The T+H+T+I regimen exhibited superior tumor control outcomes, with an ORR of 54% and DCR of 76%. However, this group also showed increased toxicity profiles, with 14 patients (28%) experiencing grade ≥3 adverse events.For patients with BCLC stage B-C HCC, the T+H+T+I combination therapy demonstrated superior survival benefits, particularly in those with tumor diameter ≥5 cm and presence of portal vein tumor thrombosis (PVTT), while maintaining an acceptable safety profile.
Keywords: hepatocellular carcinoma1, Transarterial chemoembolization2, Hepatic arterial infusion chemotherapy3, tyrosine kinase inhibitors4, Immune checkpoint inhib-itors5, propensity score matching6
Received: 21 Apr 2025; Accepted: 30 Jun 2025.
Copyright: © 2025 Liu, Yin, Chen, Hou, Li, Liu and Liu. 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: RuiBao Liu, Harbin Medical University Cancer Hospital, Harbin, China
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