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ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 38 Issue 12
Dec.  2022
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Article Navigation >  Journal of Clinical Hepatology  > 2022  >  38(12): 2755-2760

Efficacy and safety of transarterial chemoembolization combined with camrelizumab and apatinib in treatment of advanced hepatocellular carcinoma

DOI: 10.3969/j.issn.1001-5256.2022.12.014

  • Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215000, China

Research funding:

The Social Development General Program of Jiangsu Province (BE20221648)

More Information
  • Corresponding author: ZHU Xiaoli, zhuxiaoli90@163.com (ORCID: 0000-0002-3507-2018)
  • Received Date: 2022-05-24
  • Accepted Date: 2022-07-14
  • Published Date: 2022-12-20
    Abstract
  •   Objective  To investigate the efficacy and safety of transarterial chemoembolization (TACE) combined with camrelizumab and apatinib in the treatment of advanced hepatocellular carcinoma (HCC).  Methods  From July 2019 to June 2021, 19 patients with advanced HCC who met the inclusion and exclusion criteria in the First Affiliated Hospital of Soochow University were enrolled in this study. All patients received TACE combined with camrelizumab and apatinib. Tumor response was assessed according to Modified Response Evaluation Criteria in Solid Tumors (mRECIST), and adverse events were assessed according to Common Terminology Criteria for Adverse Events (v5.0). The Kaplan-Meier method was used to analyze progression-free survival and overall survival and calculate 95% confidence interval (CI).  Results  The median follow-up time was 14.0 months for the 19 patients. As of the last follow-up based on mRECIST, 7 patients (7/19, 36.8%) achieved complete response, 9 (9/19, 47.4%) achieved partial response, and 2 (2/19, 10.5%) achieved stable disease. During follow-up, overall objective response rate and overall disease control rate reached 84.2% and 94.7%, respectively; the median duration of response reached 8.0 (3.4-13.0) months, and median progression-free survival reached 9.5 (95%CI: 4.7-14.3) months; the 6-month survival rate reached 100%, and the 12-month survival rate reached 78.9%. Among the 19 patients, 7 (36.8%) experienced serious adverse events. The most common adverse events of all grades included post-embolization syndrome after TACE (17/19, 89.5%), liver injury (14/19, 73.7%), hematologic toxicity (8/19, 42.1%), and proteinuria (8/19, 42.1%).  Conclusion  TACE combined with camrelizumab and apatinib has marked efficacy and controllable adverse events in the treatment of advanced HCC, which provides a potential new option for the first-line treatment of advanced HCC.

     

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    • References(25)
  • [1]
    SUNG H, FERLAY J, SIEGEL RL, et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71(3): 209-249. DOI: 10.3322/caac.21660.
    [2]
    EL-SERAG HB, RUDOLPH KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis[J]. Gastroenterology, 2007, 132(7): 2557-2576. DOI: 10.1053/j.gastro.2007.04.061.
    [3]
    European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma[J]. J Hepatol, 2018, 69(1): 182-236. DOI: 10.1016/j.jhep.2018.03.019.
    [4]
    General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer (2022 edition)[J]. J Clin Hepatol, 2022, 38(2): 288-303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.

    国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38(2): 288-303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.
    [5]
    KUDO M, MATSUI O, IZUMI N, et al. Transarterial chemoembolization failure/refractoriness: JSH-LCSGJ criteria 2014 update[J]. Oncology, 2014, 87(Suppl 1): 22-31. DOI: 10.1159/000368142.
    [6]
    ARIZUMI T, UESHIMA K, CHISHINA H, et al. Validation of the criteria of transcatheter arterial chemoembolization failure or refractoriness in patients with advanced hepatocellular carcinoma proposed by the LCSGJ[J]. Oncology, 2014, 87(Suppl 1): 32-36. DOI: 10.1159/000368143.
    [7]
    KUDO M. Systemic therapy for hepatocellular carcinoma: 2017 Update[J]. Oncology, 2017, 93(Suppl 1): 135-146. DOI: 10.1159/000481244.
    [8]
    KUDO M, UESHIMA K, IKEDA M, et al. Randomised, multicentre prospective trial of transarterial chemoembolisation (TACE) plus sorafenib as compared with TACE alone in patients with hepatocellular carcinoma: TACTICS trial[J]. Gut, 2020, 69(8): 1492-1501. DOI: 10.1136/gutjnl-2019-318934.
    [9]
    XU J, SHEN J, GU S, et al. Camrelizumab in combination with apatinib in patients with advanced hepatocellular carcinoma (RESCUE): A nonrandomized, open-label, phase Ⅱ trial[J]. Clin Cancer Res, 2021, 27(4): 1003-1011. DOI: 10.1158/1078-0432.CCR-20-2571.
    [10]
    REN Z, XU J, BAI Y, et al. Sintilimab plus a bevacizumab biosimilar (IBI305) versus sorafenib in unresectable hepatocellular carcinoma (ORIENT-32): a randomised, open-label, phase 2-3 study[J]. Lancet Oncol, 2021, 22(7): 977-990. DOI: 10.1016/S1470-2045(21)00252-7.
    [11]
    FINN RS, QIN S, IKEDA M, et al. Atezolizumab plus bevacizumab in unresectable hepatocellular carcinoma[J]. N Engl J Med, 2020, 382(20): 1894-1905. DOI: 10.1056/NEJMoa1915745.
    [12]
    QIN S, REN Z, MENG Z, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial[J]. Lancet Oncol, 2020, 21(4): 571-580. DOI: 10.1016/S1470-2045(20)30011-5.
    [13]
    QIN S, LI Q, GU S, et al. Apatinib as second-line or later therapy in patients with advanced hepatocellular carcinoma (AHELP): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial[J]. Lancet Gastroenterol Hepatol, 2021, 6(7): 559-568. DOI: 10.1016/S2468-1253(21)00109-6.
    [14]
    LENCIONI R, LLOVET JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma[J]. Semin Liver Dis, 2010, 30(1): 52-60. DOI: 10.1055/s-0030-1247132.
    [15]
    BASCH E, REEVE BB, MITCHELL SA, et al. Development of the National Cancer Institute's patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE)[J]. J Natl Cancer Inst, 2014, 106(9): 67-73. DOI: 10.1200/EDBK_159514.
    [16]
    JU S, ZHOU C, YANG C, et al. Apatinib plus camrelizumab with/without chemoembolization for hepatocellular carcinoma: A real-world experience of a single center[J]. Front Oncol, 2021, 11: 835889. DOI: 10.3389/fonc.2021.835889.
    [17]
    CAO F, YANG Y, SI T, et al. The efficacy of TACE combined with lenvatinib plus sintilimab in unresectable hepatocellular carcinoma: A multicenter retrospective study[J]. Front Oncol, 2021, 11: 783480. DOI: 10.3389/fonc.2021.783480.
    [18]
    LIU J, LI Z, ZHANG W, et al. Comprehensive treatment of trans-arterial chemoembolization plus lenvatinib followed by camrelizumab for advanced hepatocellular carcinoma patients[J]. Front Pharmacol, 2021, 12: 709060. DOI: 10.3389/fphar.2021.709060.
    [19]
    LI KY, WEI GW, LI T, et al. Diagnosis and treatment specification for immunosuppressive therapy a rejection of liver transplantation in China(2019 edition)[J]. Ogran Transplant, 2022, 13(5): 561-568. DOI: 10.3969/j.issn.1674-7445.2022.05.003.

    李克跃, 魏国微, 黎涛, 等. 肝癌肝移植手术前后靶向及免疫治疗的指征及时机探讨[J]. 器官移植, 2022, 13(5): 561-568. DOI: 10.3969/j.issn.1674-7445.2022.05.003.
    [20]
    GOLFIERI R, RENZULLI M, MOSCONI C, et al. Hepatocellular carcinoma responding to superselective transarterial chemoembolization: an issue of nodule dimension?[J]. J Vasc Interv Radiol, 2013, 24(4): 509-517. DOI: 10.1016/j.jvir.2012.12.013.
    [21]
    KUDO M, HAN KH, YE SL, et al. A changing paradigm for the treatment of intermediate-stage hepatocellular carcinoma: Asia-Pacific primary liver cancer expert consensus statements[J]. Liver Cancer, 2020, 9(3): 245-260. DOI: 10.1159/000507370.
    [22]
    KUDO M, UESHIMA K, CHAN S, et al. Lenvatinib as an initial treatment in patients with intermediate-stage hepatocellular carcinoma beyond up-to-seven criteria and child-pugh a liver function: A proof-of-concept study[J]. Cancers (Basel), 2019, 11(8): 1084. DOI: 10.3390/cancers11081084.
    [23]
    SCHICHO A, HELLERBRAND C, KRVGER K, et al. Impact of different embolic agents for transarterial chemoembolization (TACE) procedures on systemic vascular endothelial growth factor (VEGF) levels[J]. J Clin Transl Hepatol, 2016, 4(4): 288-292. DOI: 10.14218/JCTH.2016.00058.
    [24]
    DING J, CHEN X, GAO Z, et al. Metabolism and pharmacokinetics of novel selective vascular endothelial growth factor receptor-2 inhibitor apatinib in humans[J]. Drug Metab Dispos, 2013, 41(6): 1195-1210. DOI: 10.1124/dmd.112.050310.
    [25]
    GRETEN TF, MAUDA-HAVAKUK M, HEINRICH B, et al. Combined locoregional-immunotherapy for liver cancer[J]. J Hepatol, 2019, 70(5): 999-1007. DOI: 10.1016/j.jhep.2019.01.027.
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