Efficacy and safety of apatinib combined with transarterial chemoembolization (TACE) in treating patients with recurrent hepatocellular carcinoma

Huiying Gu; Jing Li; Nan You; Ke Wu; Zheng Wang; Liang Wang; Yinan Zhu; Qinqin Liu; Xuehui Peng; Lu Zheng

doi:10.21037/atm-20-7244

Efficacy and safety of apatinib combined with transarterial chemoembolization (TACE) in treating patients with recurrent hepatocellular carcinoma

Ann Transl Med. 2020 Dec;8(24):1677. doi: 10.21037/atm-20-7244.

Authors

Huiying Gu¹, Jing Li¹, Nan You¹, Ke Wu¹, Zheng Wang¹, Liang Wang¹, Yinan Zhu¹, Qinqin Liu¹, Xuehui Peng¹, Lu Zheng¹

Affiliation

¹ Department of Hepatobiliary Surgery, Xinqiao Hospital, Army Medical University, Chongqing, China.

Abstract

Background: Apatinib, a vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor, has shown promising therapeutic effect for hepatocellular carcinoma (HCC). This prospective clinical study was implemented to evaluate the efficacy and safety of apatinib combined with transarterial chemoembolization (TACE) versus TACE alone in treating patients with recurrent HCC after hepatectomy.

Methods: Eligible patients with postoperative recurrent HCC from January 2018 to January 2020 were enrolled at the Xinqiao Hospital of Army Medical University. Patients were randomized 1:1 into TACE plus apatinib group or TACE-alone group. The clinical information of patients was collected, and the patients were followed up until untreatable progression or the end of the study. Adverse events (AEs), overall survival (OS) and progression-free survival (PFS) between the two groups were evaluated. In addition, the objective response rate (ORR) and the disease control rate (DCR) were determined according to the modified Response Evaluation Criteria In Solid Tumors (mRECIST). Among those indexes, PFS was the primary endpoint.

Results: This study enrolled 80 patients with recurrent HCC, and the demographics and primary tumor characteristics were balanced between the two groups. However, TACE plus apatinib treatment could significantly improve the median PFS of patients when compared with the TACE-alone group (17.2 vs. 12.5 months, P=0.041). The 1- and 2-year overall survival (OS) rates showed a tendency of improving in the TACE plus apatinib group, but not significantly (95.0% vs. 85.0%, and 90.0% vs. 75.0%; both P>0.05). Furthermore, the TACE plus apatinib treatment did significantly increase the short-term ORR and DCR when compared with the TACE-alone group (all P<0.05). And no unexpected toxicity or procedure-related mortality was occurred during this study.

Conclusions: The combination treatment of apatinib and TACE might be safe and of potential benefit on patients with intrahepatic recurrent HCC.

Keywords: Hepatocellular carcinoma (HCC); apatinib; transarterial chemoembolization (TACE).