Drug-eluting beads transarterial chemoembolization combined apatinib/camrelizumab for advanced hepatocellular carcinoma with hepatic arterioportal shunts

Abstract Objective The objective of this study was to evaluate the efficacy and safety of drug-eluting beads transarterial chemoembolization (D-TACE) combined with apatinib/camrelizumab in advanced hepatocellular carcinoma (HCC) patients with hepatic arterioportal shunts (APS). Methods From January 2021 to December 2022, consecutive medical records of advanced HCC patients with APS receiving D-TACE combined apatinib/camrelizumab were reviewed for eligibility. Overall survival (OS), progression-free survival (PFS), tumor response, and adverse events (AEs) were assessed. Results A total of 23 patients were included in this study, and the median follow-up time was 11 months (range, 2–26 months). In this study, 8 patients (34.8%) achieved PR, 13 patients (56.5%) achieved SD, and 2 patients (8.7%) developed PD. The objective response rate and disease controlled rate were 34.8% and 91.3%, respectively. OS and PFS were 11 months and 7 months, respectively. Multivariate analysis indicated that tumor number was an independent prognostic factor affecting PFS. AEs occurred in 19 patients after oral apatinib and in 8 patients after camrelizumab treatment. No treatment-related death occurred. Conclusions D-TACE combined with apatinib/camrelizumab had meaningful efficacy and controllable AEs in advanced HCC patients with APS, which may be a promising treatment option. Advances in knowledge •1.We investigate a new treatment strategy for advanced HCC patients with hepatic arterioportal shunts；2.D-TACE combined with apatinib/camrelizumab had meaningful efficacy and controllable AEs in advanced HCC patients with APS, which may be a promising treatment option.