Chen X, Sun XH, Xiao Y, Zhang D, Lu XY, Fu CL, Bi C, Wang X. Efficacy and safety of transarterial chemoembolization with chemotherapy, PD-1/PD-L1 inhibitors, and tyrosine kinase inhibitors in unresectable intrahepatic cholangiocarcinoma. World J Gastrointest Oncol 2025; 17(9): 103816 [DOI: 10.4251/wjgo.v17.i9.103816]
Corresponding Author of This Article
Xia Wang, Chief Physician, Department of Radiation Oncology, The Affiliated Hospital of Xuzhou Medical University, No. 9 Kunpeng North Road, Xuzhou 221006, Jiangsu Province, China. wangxia_66@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Cohort 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. Sep 15, 2025; 17(9): 103816 Published online Sep 15, 2025. doi: 10.4251/wjgo.v17.i9.103816
Efficacy and safety of transarterial chemoembolization with chemotherapy, PD-1/PD-L1 inhibitors, and tyrosine kinase inhibitors in unresectable intrahepatic cholangiocarcinoma
Xiao Chen, Xi-Heng Sun, Yue Xiao, Dan Zhang, Xiao-Yan Lu, Cheng-Lei Fu, Chun Bi, Xia Wang
Xiao Chen, Yue Xiao, Dan Zhang, Xia Wang, Department of Radiation Oncology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu Province, China
Xi-Heng Sun, Department of Medical College, Yangzhou University Medical College, Yangzhou 225100, Jiangsu Province, China
Xiao-Yan Lu, Cheng-Lei Fu, Chun Bi, Department of Oncology, Siyang Hospital, Suqian 223700, Jiangsu Province, China
Co-first authors: Xiao Chen and Xi-Heng Sun.
Co-corresponding authors: Chun Bi and Xia Wang.
Author contributions: Chen X analyzed the data and wrote the manuscript; Chen X, Sun XH, Bi C, and Wang X designed the research study; Chen X, Xiao Y, Zhang D, and Lu XY performed the research; Zhang D, Fu CL, Bi C, and Wang X provided financial support; Chen X and Sun XH contributed equally to this article and are co-first authors of this manuscript; Bi C and Wang X made equally important contributions to the design, implementation and writing of this study and are the co-corresponding authors of this manuscript.
Institutional review board statement: This study was reviewed and approved by the Institutional Review Board of the Affiliated Hospital of Xuzhou Medical University (Approval No. XYFY2024-KL618-01).
Informed consent statement: As the study used anonymous and pre-existing data, the requirement for the informed consent from patients was waived.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Data sharing statement: The authors declare that all data and materials supporting the findings of this study are available within the article.
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: Xia Wang, Chief Physician, Department of Radiation Oncology, The Affiliated Hospital of Xuzhou Medical University, No. 9 Kunpeng North Road, Xuzhou 221006, Jiangsu Province, China. wangxia_66@163.com
Received: January 5, 2025 Revised: June 29, 2025 Accepted: August 1, 2025 Published online: September 15, 2025 Processing time: 253 Days and 21.1 Hours
Abstract
BACKGROUND
Chemotherapy, targeted therapy, and immunotherapy have all been shown to achieve some efficacy in treating intrahepatic cholangiocarcinoma (ICC). However, these systemic treatments have not provided optimal results for some patients. Therefore, the combination of transarterial chemoembolization (TACE) and hepatic artery infusion chemotherapy or other local interventional therapy methods is being considered for the treatment of liver tumors.
AIM
To evaluate the efficacy and safety of combining chemotherapy, targeted therapy, and immunotherapy, with or without TACE, in patients with ICC.
METHODS
We recruited 83 patients with unresectable ICC from July 2021 to December 2023 at the Affiliated Hospital of Xuzhou Medical University. Forty-one patients received TACE combined with chemotherapy, tyrosine kinase inhibitors, and programmed death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitors (experimental group), whereas 42 patients were treated with chemotherapy, tyrosine kinase inhibitors, and PD-1/PD-L1 inhibitors (control group). Short-term efficacy was assessed using the modified response evaluation criterion, and the objective response rate, disease control rate, progression-free survival, and incidence of adverse events were compared between groups.
RESULTS
The objective response rate in the experimental group was greater than that in the control group (39.0% vs 19.0%, P < 0.05). The disease control rate in the experimental group was significantly greater than that in the control group (75.6% vs 52.4%, P < 0.05). The median progression-free survival times were 14.3 months in the experimental group and 12.7 months in the control group (P < 0.05). All 41 patients in the experimental group developed postembolization syndrome. Among the symptoms, fever and pain were significantly more common in the experimental group than in the control group (85.4% vs 11.9%, P < 0.001 and 58.5% vs 9.5%, P < 0.001). No grade 4 or 5 treatment-related adverse events were observed in either group.
CONCLUSION
In patients with unresectable ICC, TACE combined with chemotherapy, tyrosine kinase inhibitors, and PD-1/PD-L1 inhibitors has good efficacy and high safety, indicating potential benefits for these patients.
Core Tip: This study retrospectively evaluated the efficacy and safety of transarterial chemoembolization combined with chemotherapy, tyrosine kinase inhibitors, and programmed death 1/programmed cell death ligand 1 inhibitors in patients with intrahepatic cholangiocarcinoma. In conclusion, the combination of transarterial chemoembolization with chemotherapy, tyrosine kinase inhibitors, and programmed death 1/programmed cell death ligand 1 inhibitors demonstrates good efficacy and a favorable safety profile, offering potential benefits for patients with intrahepatic cholangiocarcinoma.
