Treatment with camrelizumab plus tyrosine kinase inhibitors with or without TACE for intermediate-advanced hepatocellular carcinoma: a clinical efficacy and safety study

Abstract

Abstract Objectives This research compared the curative effect and safety of camrelizumab plus tyrosine kinase inhibitors (TKIs) combined with transcatheter arterial chemoembolization (TACE) to those of camrelizumab plus TKIs for the treatment of intermediate-advanced hepatocellular carcinoma (HCC). Methods From January 2019 to July 2021, 47 patients with intermediate-advanced HCC were included in this retrospective study. After screening, 44 eligible patients were split into two arms: the camrelizumab + TKI + TACE arm (n=28) and the camrelizumab + TKI arm (n=16). The primary endpoints were overall survival (OS) and progression-free survival (PFS), while tumor response and adverse events (AEs) served as secondary endpoints. Results The median OS was 12.60 months for the 44 patients. The median PFS (p=0.0248, 7.20 vs. 3 months), objective response rate (ORR) (21.43 vs. 6.25%) and disease control rate (DCR) (57.14 vs. 18.75%) were better for patients in the camrelizumab + TKI + TACE arm than in the camrelizumab + TKI arm. After correcting for the effects of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBil) levels, the treatment effect of the camrelizumab + TKI + TACE arm (HR=0.330, 95% CI=0.130–0.880, p=0.026) was still superior. The common AEs in the two groups included reactive cutaneous capillary hyperplasia (n=17), myelosuppression (n=19) and liver dysfunction (n=12). However, AEs of grade ≥3 were equal between the groups. Conclusions Camrelizumab + TKI + TACE therapy was more effective than camrelizumab + TKI therapy for intermediate-advanced HCC, and toxicity was manageable.