TACE–HAIC combined with apatinib and camrelizumab for unresectable hepatocellular carcinoma with portal vein tumor thrombus: a multicenter retrospective study
6 affiliations
- 1Department of Interventional Medicine, The First Affiliated Hospital of Guangzhou Medical University , , ,
- 2Department of Interventional Medicine, The Second Affiliated Hospital of Wenzhou Medical University , , ,
- 3Hepatobiliary and Pancreatic Interventional Treatment Center, Division of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital, Zhejiang University School of Medicine , , ,
- 4Department of Interventional Radiology, The First Affiliated Hospital of Kunming Medical University , , ,
- 5Department of Interventional Radiology, Qujing Second People’s Hospital , , ,
- 6Department of Vascular and Interventional Radiology, Jingmen People’s Hospital, Jingchu University of Technology Affiliated Jingmen People’s Hospital , , ,
Abstract
Background and objectives: Unresectable hepatocellular carcinoma (uHCC) with portal vein tumor thrombus (PVTT) indicates a poor prognosis. This study aims to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with hepatic arterial infusion chemotherapy (HAIC), apatinib, and camrelizumab in patients with uHCC accompanied by PVTT.
Methods: This multicenter retrospective study included patients with uHCC and PVTT who were treated at five tertiary medical centers in China between December 2021 and April 2025. Propensity score matching (PSM) was performed to minimize potential confounding bias. Treatment efficacy was assessed by objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). The primary endpoints were PFS and OS, whereas secondary endpoints included ORR and safety.
Results: Among the 222 patients who met the eligibility criteria, 105 received TACE-HAIC combined with apatinib and camrelizumab (THAC group), and 117 received TACE combined with apatinib and camrelizumab (TAC group). After PSM, 86 matched patients were included in each group, and baseline characteristics were well balanced between the two groups. The THAC group achieved significantly higher intrahepatic tumor ORR (70.9% vs. 47.7%, P = 0.002) and DCR (94.2% vs. 79.1%, P = 0.004) than the TAC group. Similarly, for PVTT, the THAC group demonstrated significantly higher ORR (61.6% vs. 41.9%, P = 0.009) and DCR (90.7% vs. 74.4%, P = 0.005). The median PFS was significantly longer in the THAC group than in the TAC group (12 months vs. 7 months; HR = 0.287; 95%CI: 0.204–0.403; P<0.001). Likewise, the median OS was significantly prolonged in the THAC group (24 months vs. 16 months; HR = 0.198; 95%CI: 0.135–0.291; P<0.001). The incidence of adverse events did not differ significantly between the two groups (P>0.05). All adverse events were manageable, and no grade 5 adverse events were observed.
Conclusions: In patients with uHCC accompanied by PVTT, the THAC regimen was associated with superior survival outcomes compared with the TAC regimen while maintaining an acceptable safety profile. These findings suggest that THAC may represent a feasible and effective therapeutic option for this patient population.
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BibTeX
@article{zhang2026tacehaic,
title = {{TACE–HAIC combined with apatinib and camrelizumab for unresectable hepatocellular carcinoma with portal vein tumor thrombus: a multicenter retrospective study}},
author = {Xuexian Zhang and Shangbo Shi and Yang Su and Yuanjin Ma and Qikun Guo and Xuerou Meng and Ruidong Wang and Jian Long and Jidong Yang and Bin Xiong},
journal = {Frontiers in immunology},
year = {2026},
month = oct,
doi = {10.3389/fimmu.2026.1917667},
url = {https://europepmc.org/article/PMC/PMC13669148},
note = {CC BY},
}
RIS
TY - JOUR
TI - TACE–HAIC combined with apatinib and camrelizumab for unresectable hepatocellular carcinoma with portal vein tumor thrombus: a multicenter retrospective study
AU - Xuexian Zhang
AU - Shangbo Shi
AU - Yang Su
AU - Yuanjin Ma
AU - Qikun Guo
AU - Xuerou Meng
AU - Ruidong Wang
AU - Jian Long
AU - Jidong Yang
AU - Bin Xiong
PY - 2026
DA - 2026/10/01
JO - Frontiers in immunology
DO - 10.3389/fimmu.2026.1917667
UR - https://europepmc.org/article/PMC/PMC13669148
AB - Background and objectives: Unresectable hepatocellular carcinoma (uHCC) with portal vein tumor thrombus (PVTT) indicates a poor prognosis. This study aims to evaluate the efficacy and safety of transarterial chemoembolization (TACE) combined with hepatic arterial infusion chemotherapy (HAIC), apatinib, and camrelizumab in patients with uHCC accompanied by PVTT. Methods: This multicenter retrospective study included patients with uHCC and PVTT who were treated at five tertiary medical centers in China between December 2021 and April 2025. Propensity score matching (PSM) was performed to minimize potential confounding bias. Treatment efficacy was assessed by objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). The primary endpoints were PFS and OS, whereas secondary endpoints included ORR and safety. Results: Among the 222 patients who met the eligibility criteria, 105 received TACE-HAIC combined with apatinib and camrelizumab (THAC group), and 117 received TACE combined with apatinib and camrelizumab (TAC group). After PSM, 86 matched patients were included in each group, and baseline characteristics were well balanced between the two groups. The THAC group achieved significantly higher intrahepatic tumor ORR (70.9% vs. 47.7%, P = 0.002) and DCR (94.2% vs. 79.1%, P = 0.004) than the TAC group. Similarly, for PVTT, the THAC group demonstrated significantly higher ORR (61.6% vs. 41.9%, P = 0.009) and DCR (90.7% vs. 74.4%, P = 0.005). The median PFS was significantly longer in the THAC group than in the TAC group (12 months vs. 7 months; HR = 0.287; 95%CI: 0.204–0.403; P<0.001). Likewise, the median OS was significantly prolonged in the THAC group (24 months vs. 16 months; HR = 0.198; 95%CI: 0.135–0.291; P<0.001). The incidence of adverse events did not differ significantly between the two groups (P>0.05). All adverse events were manageable, and no grade 5 adverse events were observed. Conclusions: In patients with uHCC accompanied by PVTT, the THAC regimen was associated with superior survival outcomes compared with the TAC regimen while maintaining an acceptable safety profile. These findings suggest that THAC may represent a feasible and effective therapeutic option for this patient population.
SN - 1664-3224
ER -