Effect of camrelizumab plus transarterial chemoembolization on massive hepatocellular carcinoma

Abstract

Objective: To investigate the efficacy of camrelizumab plus transarterial chemoembolization (TACE) on massive hepatocellular carcinoma (HCC) patients.

Methods: A total of 92 cases with massive HCC from October 2019 to January 2021 were prospectively enrolled and randomly divided into the study group (n = 46) and the control group (n = 46). The control group received TACE while the study group were treated with camrelizumab plus TACE. The primary end points were clinical efficacy and adverse events. And the secondary end points were liver function, and alpha fetoprotein (AFP), carcino-embryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9) levels before and after treatment.

Results: All participants were followed-up for 7 to 24 months, with a median of 12 months. Patients in the study group received TACE for 1-3 times, with an average of (2.01 ± 0.09) times, while patients in the control group receive TACE for 2-4 times, with an average of (3.78 ± 0.12) times, and the control group received significantly more TACEs (χ² = 5.518, P = 0.019). During the follow-up, the response rate and disease control rate of the study group were significantly higher than those of the control group (χ² = 5.518, P = 0.019; χ² = 4.467, P = 0.041). Before treatment, the levels of total bilirubin (TBIL), alanine aminotransferase (ALT), aspartate aminotransferase (AST), alpha-fetoprotein (AFP), CEA, and CA19-9 were comparable between the groups (P > 0.05). After treatment, the levels of TBIL, ALT, AST, AFP, CEA, and CA19-9 decreased, and the above indicators in the study group were significantly lower than those in the control group (P < 0.05). All patients showed transient liver damage, vomiting, nausea, fever and abdominal pain after surgery, and their symptoms were relieved after symptomatic treatment. Adverse events occurred in 9 cases in the study group, and 3 cases in the control group (χ² = 3.419, P = 0.064).

Conclusion: Compared with TACE alone, camrelizumab plus TACE treatment can significantly improve the liver function of patients with massive HCC and enhance the treatment effect, which is worthy of clinical promotion.

Keywords: Alt: alanine aminotransferase; Ast: aspartate aminotransferase; Ca19-9: carbohydrate antigen 19-9; Camrelizumab; Cea: carcino-embryonic antigen; Cnlc: Chinese liver cancer; Dcr: Disease control rate; Hcc: hepatocellular carcinoma; Liver function Abbreviations Afp: alpha fetal protein; Massive hepatocellular carcinoma; Mrecist: modified Response Evaluation Criteria in Solid Tumors; Pd: Progressive disease; Pfs: Progression-free survival; Pr: Partial response; Rr: Response rate; Sd: Stable disease; Tace: transarterial chemoembolization; Tbil: total bilirubin; Transarterial chemoembolization.