Hou Xunbo, Xu Qiannan, Yin Linan, Wang Huiwen, Wu Juan, Liu Bowen, He Dongfeng, Liu Ruibao
Department of Interventional Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China.
Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China.
Oncol Lett. 2025 May 23;30(1):363. doi: 10.3892/ol.2025.15109. eCollection 2025 Jul.
Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) presents a notable therapeutic challenge. The efficacy of transarterial chemoembolization (TACE) combined with hepatic arterial infusion chemotherapy (HAIC) and systemic therapy using tyrosine kinase inhibitor and programmed cell death protein 1 inhibitor has not been fully explored. In the present study, the clinical data from 251 patients with HCC and PVTT treated at Harbin Medical University Cancer Hospital (Harbin, China) between January 2021 and December 2022 were retrospectively analyzed. Patients were divided into four groups: TACE-HAIC + lenvatinib + camrelizumab (Group 1; n=16), TACE + lenvatinib + camrelizumab (Group 2; n=90), HAIC + lenvatinib + camrelizumab (Group 3; n=102) and TACE alone (Group 4; n=43). Clinical data included demographics, preoperative indices, tumor characteristics, medical history, performance status, liver function, pre-treatment α-fetoprotein levels and adverse events. Survival outcomes [overall survival (OS) and progression-free survival (PFS)] were analyzed using Kaplan-Meier survival curves. Group 1 exhibited significantly longer OS and PFS times compared with Group 4 (both P<0.05). Adverse events, including fatigue, diarrhea, nausea, vomiting and immune-related pneumonitis, were more frequent in Group 1 (all P<0.001). Group 2 also showed improved OS and PFS times compared with Group 4 (both P<0.05), with notable differences in adverse event profiles. Group 3 demonstrated superior survival outcomes compared with Group 4 (P<0.05), although with a higher incidence of adverse events. No significant differences in OS or PFS times were observed between Groups 1 and 3, or between Groups 2 and 3, indicating comparable efficacy between TACE-HAIC + lenvatinib + camrelizumab and HAIC + lenvatinib + camrelizumab. In conclusion, TACE-HAIC combined with lenvatinib and camrelizumab significantly improved both OS and PFS times in patients with HCC and PVTT compared with TACE alone, despite a higher incidence of adverse events. This combination therapy represents a promising treatment strategy for this patient population, offering enhanced survival benefits.
伴有门静脉癌栓（PVTT）的肝细胞癌（HCC）带来了显著的治疗挑战。经动脉化疗栓塞（TACE）联合肝动脉灌注化疗（HAIC）以及使用酪氨酸激酶抑制剂和程序性细胞死亡蛋白1抑制剂的全身治疗的疗效尚未得到充分探索。在本研究中，对2021年1月至2022年12月期间在哈尔滨医科大学附属肿瘤医院（中国哈尔滨）接受治疗的251例HCC合并PVTT患者的临床资料进行了回顾性分析。患者被分为四组：TACE-HAIC + 仑伐替尼 + 卡瑞利珠单抗（第1组；n = 16）、TACE + 仑伐替尼 + 卡瑞利珠单抗（第2组；n = 90）、HAIC + 仑伐替尼 + 卡瑞利珠单抗（第3组；n = 102）和单纯TACE（第4组；n = 43）。临床资料包括人口统计学信息、术前指标、肿瘤特征、病史、体能状态、肝功能、治疗前甲胎蛋白水平和不良事件。使用Kaplan-Meier生存曲线分析生存结局[总生存期（OS）和无进展生存期（PFS）]。与第4组相比，第1组的OS和PFS时间显著更长（均P<0.05）。第1组中包括疲劳、腹泻、恶心、呕吐和免疫相关肺炎在内的不良事件更为频繁（均P<0.001）。与第4组相比，第2组的OS和PFS时间也有所改善（均P<0.05），不良事件谱存在显著差异。与第4组相比，第3组显示出更好的生存结局（P<0.05），尽管不良事件发生率更高。在第1组和第3组之间，以及第2组和第3组之间，OS或PFS时间均未观察到显著差异，表明TACE-HAIC + 仑伐替尼 + 卡瑞利珠单抗与HAIC + 仑伐替尼 + 卡瑞利珠单抗的疗效相当。总之，与单纯TACE相比，TACE-HAIC联合仑伐替尼和卡瑞利珠单抗显著改善了HCC合并PVTT患者的OS和PFS时间，尽管不良事件发生率更高。这种联合治疗代表了针对该患者群体的一种有前景的治疗策略，可带来更高的生存获益。
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