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.