Efficacy and safety of combined TACE-HAIC and targeted immunotherapy in primary liver cancer with portal vein tumor thrombus.

OBJECTIVE

This study aims to assess the efficacy and safety of combining transarterial chemoembolization and hepatic arterial infusion chemotherapy (TACE-HAIC) with targeted immunotherapy in patients with primary hepatocellular carcinoma (HCC) complicated by portal vein tumor thrombus (PVTT).

METHODS

We retrospectively analyzed clinical data from 114 patients with HCC and PVTT treated with either a quadruple-therapy group (TACE-HAIC plus targeted immunotherapy) or a triple-therapy group (TACE plus targeted immunotherapy) at the Affiliated Hospital of Xuzhou Medical University from January 2019 to September 2023. Propensity score matching was applied to these 114 patients. We compared outcomes such as overall survival (OS), progression-free survival (PFS), intrahepatic progression-free survival (IHPFS), PVTT progression-free survival (TTPFS), objective response rate (ORR), disease control rate (DCR), and the incidence of adverse events between the groups.

RESULTS

The quadruple-therapy group exhibited a markedly superior ORR of portal vein tumor thrombus relative to the triple-therapy group (P<0.05). However, no significant differences were found between the groups in OS, PFS, IHPFS, or TTPFS (P > 0.05).

CONCLUSION

The combination of TACE-HAIC with targeted immunotherapy (the quadruple-therapy group) is an effective treatment strategy for PVTT, significantly inducing regression of intraportal tumor thrombi and achieving a higher objective response rate.