Zuo MX, An C, Cao YZ, Pan JY, Xie LP, Yang XJ, Li W, Wu PH. Camrelizumab, apatinib and hepatic artery infusion chemotherapy combined with microwave ablation for advanced hepatocellular carcinoma. World J Gastrointest Oncol 2024; 16(8): 3481-3495 [PMID: 39171171 DOI: 10.4251/wjgo.v16.i8.3481]
Corresponding Author of This Article
Pei-Hong Wu, Doctor, Doctor, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Yuexiu District, Guangzhou 510060, Guangdong Province, China. wuph@sysucc.org.cn
Research Domain of This Article
Oncology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Aug 15, 2024; 16(8): 3481-3495 Published online Aug 15, 2024. doi: 10.4251/wjgo.v16.i8.3481
Camrelizumab, apatinib and hepatic artery infusion chemotherapy combined with microwave ablation for advanced hepatocellular carcinoma
Meng-Xuan Zuo, Chao An, Yu-Zhe Cao, Jia-Yu Pan, Lu-Ping Xie, Xin-Jing Yang, Wang Li, Pei-Hong Wu
Meng-Xuan Zuo, Yu-Zhe Cao, Jia-Yu Pan, Lu-Ping Xie, Xin-Jing Yang, Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Chao An, Department of Interventional Ultrasound, Chinese General PLA Hospital, Beijing 100853, China
Wang Li, Pei-Hong Wu, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Author contributions: Zuo MX and An C participated equally in the acquisition, analysis, and interpretation of the data, created the figures and tables, and drafted the manuscript; Cao YZ completed the statistical analysis; Zuo MX and Cao YZ reviewed all patient data; Pan JY, Xie LP, Yang XJ, and Li W performed critical revisions of the manuscript; Zuo MX and Wu PH agreed to be accountable for ensuring that questions related to the accuracy and integrity of any part of the manuscript were appropriately investigated and resolved; Zuo MX, An C, and Wu PH made substantial contributions to the conception and design of the study and provided final approval of the manuscript version to be submitted for publication.
Institutional review board statement: This retrospective study was approved by the Institutional Review Board of Sun Yat-sen University Cancer Center, Guangzhou, China (B2023-411-01).
Informed consent statement: Informed consent was waived due to the retrospective nature of the analysis.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The data that support the findings of this study are available on request from the corresponding author, upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pei-Hong Wu, Doctor, Doctor, Department of Medical Imaging and Interventional Radiology, Sun Yat-sen University Cancer Center, No. 651 Dongfeng Road East, Yuexiu District, Guangzhou 510060, Guangdong Province, China. wuph@sysucc.org.cn
Received: February 3, 2024 Revised: May 1, 2024 Accepted: June 12, 2024 Published online: August 15, 2024 Processing time: 187 Days and 3.7 Hours
Abstract
BACKGROUND
Hepatic arterial infusion chemotherapy and camrelizumab plus apatinib (TRIPLET protocol) is promising for advanced hepatocellular carcinoma (Ad-HCC). However, the usefulness of microwave ablation (MWA) after TRIPLET is still controversial.
AIM
To compare the efficacy and safety of TRIPLET alone (T-A) vs TRIPLET-MWA (T-M) for Ad-HCC.
METHODS
From January 2018 to March 2022, 217 Ad-HCC patients were retrospectively enrolled. Among them, 122 were included in the T-A group, and 95 were included in the T-M group. A propensity score matching (PSM) was applied to balance bias. Overall survival (OS) was compared using the Kaplan-Meier curve with the log-rank test. The overall objective response rate (ORR) and major complications were also assessed.
RESULTS
After PSM, 82 patients were included both the T-A group and the T-M group. The ORR (85.4%) in the T-M group was significantly higher than that (65.9%) in the T-A group (P < 0.001). The cumulative 1-, 2-, and 3-year OS rates were 98.7%, 93.4%, and 82.0% in the T-M group and 85.1%, 63.1%, and 55.0% in the T-A group (hazard ratio = 0.22; 95% confidence interval: 0.10-0.49; P < 0.001). The incidence of major complications was 4.9% (6/122) in the T-A group and 5.3% (5/95) in the T-M group, which were not significantly different (P = 1.000).
CONCLUSION
T-M can provide better survival outcomes and comparable safety for Ad-HCC than T-A.
Core Tip: Microwave ablation (MWA) and hepatic arterial infusion chemotherapy (HAIC) are important locoregional therapy for advanced hepatocellular carcinoma (HCC). HAIC with anti-angiogenesis agents and programmed cell death protein 1 inhibitiors [camrelizumab plus apatinib and hepatic artery infusion chemotherapy (TRIPLET)] followed by MWA contribute to better outcome than TRIPLET alone. Combination of locoregional therapy improve prognosis of advanced HCC.
