Clinical efficacy of HAIC combined with TACE in patients with unresectable intrahepatic cholangiocarcinoma.

OBJECTIVE: To evaluate the efficacy and safety of combined treatment based on hepatic arterial infusion chemotherapy (HAIC) and transarterial chemoembolization (TACE) in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). MATERIALS AND METHODS: A total of 82 patients with unresectable ICC were retrospectively included in this study. Of these,40 patients received HAIC combined with TACE treatment (HAIC+TACE group) and 42 received intravenous chemotherapy (Chemo group). Propensity score matching (PSM) was performed to reduce selection bias between the HAIC+TACE group and the Chemo group. Efficacy was evaluated using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) 1.1. Differences in tumor response, progression-free survival (PFS), overall survival (OS), and adverse events were compared between the two groups. RESULTS: The HAIC+TACE group had a higher disease control rate (97.5% vs. 81.0%, P = 0.030) compared to the Chemo group. The objective response rate was similar between the groups (65.0% vs. 64.3%). The median OS was 13.90 months (95% CI 9.10–18.40) in the HAIC+TACE group and 13.40 months (95% CI 9.90–23.70) in the Chemo group. The PFS in the HAIC+TACE group was significantly longer in the Chemo group (8.45 months vs. 6.65 months, P = 0.039). No significant difference in adverse events was observed between the two groups. CONCLUSION: HAIC combined with TACE demonstrates a higher DCR and PFS in the treatment of unresectable ICC, with manageable adverse reactions. Although no significant difference in OS was observed, HAIC combined with TACE may offer a promising option for improving disease control and potentially delaying disease progression compared to standard chemotherapy.