Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis.

Apatinib is a powerful inhibitor of vascular endothelial growth factor receptor-2. This study was aimed to investigate whether apatinib could improve the efficacy of transarterial chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC). Between June 2015 and September 2018, 357 patients with HCC at Barcelona Clinic Liver Cancer stage C who received the treatment of TACE combining with apatinib (TACE-apatinib) or TACE-alone were included. Propensity score matching (PSM) analysis was used to reduce the patient selection bias. Ninety pairs of patients were chosen after the PSM analysis. The disease control rates of tumor and a-fetoprotein response in the TACE-apatinib group were significantly higher than that of the TACE-alone group before and after the PSM analysis ( < 0.05). Before the PSM analysis, the median time of tumor progression (TTP) and the overall survival (OS) in the TACE-apatinib group were significantly greater than those of the TACE-alone group (TTP: 9.0 months vs. 3.0 months, < 0.001; OS: 14.0 months vs. 7.0 months, < 0.001). After the PSM analysis, the median TTP and OS in the TACE-apatinib group was also significantly greater than that of the TACE-alone group (TTP: 7.0 months vs. 3.0 months, < 0.001; OS: 13.0 months vs. 8.0 months, < 0.001); the uni- and multivariate analysis revealed that TACE-apatinib was a protective factor for OS. Fourteen patients emerged with grade 3 apatinib-related adverse events. The efficacy of TACE-apatinib for patients with advanced HCC was inspiring, and the side effects of apatinib were tolerable.