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Background <p>Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and treatment outcomes remain poor for advanced cases, especially those with portal vein tumor thrombus. Although transarterial chemoembolization (TACE) is widely applied, its efficacy is limited. Recent studies suggest that combining immunotherapy with targeted therapy may improve prognosis.</p> Methods <p>We retrospectively analyzed 104 patients with unresectable HCC treated between October 2020 and October 2023. Patients were divided into a TACE monotherapy group (<i>n</i> = 53) and a combination group receiving TACE plus camrelizumab and apatinib (<i>n</i> = 39). Tumor response was assessed by mRECIST criteria, and survival outcomes were analyzed using Kaplan–Meier methods. Safety profiles were also evaluated.</p> Results <p>The objective response rate (ORR) was significantly higher in the combination group compared to TACE alone (64.1% vs. 37.7%, <i>P</i> = 0.012), while the disease control rate (DCR) was similar (76.9% vs. 77.4%). The median progression-free survival (mPFS) was prolonged in the combination group (9.0 vs. 6.0 months; HR = 0.60, 95% CI 0.383–0.941; <i>P</i> = 0.019). The median overall survival (mOS) showed a trend toward improvement but did not reach statistical significance (16.0 vs. not reached; HR = 0.548, 95% CI 0.298–1.006; <i>P</i> = 0.06). Adverse events were mostly Grade 1–2, with the most frequent being weight loss, abdominal pain, and fatigue. No unexpected or severe immune-related toxicities were observed. One patient developed hyperprogressive disease with rapid intrahepatic metastasis and subsequent liver failure.</p> Conclusions <p>TACE combined with camrelizumab and apatinib demonstrated superior tumor response and progression-free survival compared to TACE alone, with an acceptable safety profile. Hyperprogression remains a critical concern, highlighting the need for early identification and standardized management guidelines in the era of immunotherapy.</p>

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The Efficiency and Safety of Tace Combined with Targeted Therapy and Immunotherapy for Advanced Hepatocellular Carcinoma

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Shunyu Kong,
  • Zhenwu Lei,
  • Le Zhang,
  • Jiangang Kang,
  • Wei Cao,
  • Haidong Yu,
  • Jiaxu Wang,
  • Wenyuan Ye,
  • Jingxin Yan

摘要

Background

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, and treatment outcomes remain poor for advanced cases, especially those with portal vein tumor thrombus. Although transarterial chemoembolization (TACE) is widely applied, its efficacy is limited. Recent studies suggest that combining immunotherapy with targeted therapy may improve prognosis.

Methods

We retrospectively analyzed 104 patients with unresectable HCC treated between October 2020 and October 2023. Patients were divided into a TACE monotherapy group (n = 53) and a combination group receiving TACE plus camrelizumab and apatinib (n = 39). Tumor response was assessed by mRECIST criteria, and survival outcomes were analyzed using Kaplan–Meier methods. Safety profiles were also evaluated.

Results

The objective response rate (ORR) was significantly higher in the combination group compared to TACE alone (64.1% vs. 37.7%, P = 0.012), while the disease control rate (DCR) was similar (76.9% vs. 77.4%). The median progression-free survival (mPFS) was prolonged in the combination group (9.0 vs. 6.0 months; HR = 0.60, 95% CI 0.383–0.941; P = 0.019). The median overall survival (mOS) showed a trend toward improvement but did not reach statistical significance (16.0 vs. not reached; HR = 0.548, 95% CI 0.298–1.006; P = 0.06). Adverse events were mostly Grade 1–2, with the most frequent being weight loss, abdominal pain, and fatigue. No unexpected or severe immune-related toxicities were observed. One patient developed hyperprogressive disease with rapid intrahepatic metastasis and subsequent liver failure.

Conclusions

TACE combined with camrelizumab and apatinib demonstrated superior tumor response and progression-free survival compared to TACE alone, with an acceptable safety profile. Hyperprogression remains a critical concern, highlighting the need for early identification and standardized management guidelines in the era of immunotherapy.