Efficacy of transarterial chemoembolization‑hepatic arterial infusion chemotherapy combined with targeted therapy and immunotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Hou,Xunbo; Xu,Qiannan; Yin,Linan; Wang,Huiwen; Wu,Juan; Liu,Bowen; He,Dongfeng; Liu,Ruibao

doi:10.3892/ol.2025.15109

Efficacy of transarterial chemoembolization‑hepatic arterial infusion chemotherapy combined with targeted therapy and immunotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Authors:
- Xunbo Hou
- Qiannan Xu
- Linan Yin
- Huiwen Wang
- Juan Wu
- Bowen Liu
- Dongfeng He
- Ruibao Liu
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Affiliations: Department of Interventional Radiology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang 150081, P.R. China, Department of Anesthesiology, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang 150001, P.R. China, Department of Radiology, The Third People's Hospital of Longgang District, Shenzhen, Guangdong 518115, P.R. China
Published online on: May 23, 2025 https://doi.org/10.3892/ol.2025.15109
Article Number: 363
Copyright: © Hou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) presents a notable therapeutic challenge. The efficacy of transarterial chemoembolization (TACE) combined with hepatic arterial infusion chemotherapy (HAIC) and systemic therapy using tyrosine kinase inhibitor and programmed cell death protein 1 inhibitor has not been fully explored. In the present study, the clinical data from 251 patients with HCC and PVTT treated at Harbin Medical University Cancer Hospital (Harbin, China) between January 2021 and December 2022 were retrospectively analyzed. Patients were divided into four groups: TACE‑HAIC + lenvatinib + camrelizumab (Group 1; n=16), TACE + lenvatinib + camrelizumab (Group 2; n=90), HAIC + lenvatinib + camrelizumab (Group 3; n=102) and TACE alone (Group 4; n=43). Clinical data included demographics, preoperative indices, tumor characteristics, medical history, performance status, liver function, pre‑treatment α‑fetoprotein levels and adverse events. Survival outcomes [overall survival (OS) and progression‑free survival (PFS)] were analyzed using Kaplan‑Meier survival curves. Group 1 exhibited significantly longer OS and PFS times compared with Group 4 (both P<0.05). Adverse events, including fatigue, diarrhea, nausea, vomiting and immune‑related pneumonitis, were more frequent in Group 1 (all P<0.001). Group 2 also showed improved OS and PFS times compared with Group 4 (both P<0.05), with notable differences in adverse event profiles. Group 3 demonstrated superior survival outcomes compared with Group 4 (P<0.05), although with a higher incidence of adverse events. No significant differences in OS or PFS times were observed between Groups 1 and 3, or between Groups 2 and 3, indicating comparable efficacy between TACE‑HAIC + lenvatinib + camrelizumab and HAIC + lenvatinib + camrelizumab. In conclusion, TACE‑HAIC combined with lenvatinib and camrelizumab significantly improved both OS and PFS times in patients with HCC and PVTT compared with TACE alone, despite a higher incidence of adverse events. This combination therapy represents a promising treatment strategy for this patient population, offering enhanced survival benefits.

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