Clinical outcomes of combined hepatic arterial infusion chemotherapy with targeted or immunotherapy in advanced hepatocellular carcinoma

This retrospective study aimed to evaluate the efficacy and safety of combining hepatic arterial infusion chemotherapy (HAIC) with tyrosine kinase inhibitors (TKIs) or immune checkpoint inhibitors (ICIs) versus HAIC alone for the treatment of advanced hepatocellular carcinoma (HCC). A total of 52 consecutive patients with advanced HCC who underwent HAIC and (or) TKIs/ICIs treatments from July 2021 to July 2023 were included in this retrospective study. Based on the different treatment regimens, these patients were divided into HAIC group ( n = 22) and HAIC + T/I group ( n = 30). The laboratory indexes, progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were analyzed. Potential factors affecting PFS and OS were evaluated by univariate and multivariate analyses. Compared to the HAIC group, the HAIC + T/I group achieved a higher objective response rate (56.7% vs. 18.2%, P = 0.005) and disease control rate (93.3% vs. 68.2%, P = 0.046). The median PFS was 7 months in the HAIC + T/I group and 4 months in the HAIC group (log-rank P = 0.070), and the median OS was 9 months and 6 months, respectively (log-rank P = 0.006). In multivariable analysis, combination treatment, prothrombin time, and alanine aminotransferase were independent prognostic factors for OS. No obvious increase in severe treatment-related adverse events was observed. The combination of HAIC with TKIs/ICIs was associated with improved tumor response and survival outcomes, particularly in selected patient subgroups, and demonstrated an acceptable safety profile in patients with advanced HCC.