Response to the Letter to the Editor received after the publication of our article: “Hepatic artery infusion chemotherapy using mFOLFOX versus transarterial chemoembolization as initial treatment for advanced hepatocellular carcinoma: a propensity score-matching analysis”

Hepatic artery infusion chemotherapy (HAIC) is a well-established and common treatment for advanced hepatocellular carcinoma (HCC), particularly in East Asia. However, HAIC is not recognized internationally. Although several trials have demonstrated the safety and efficacy of HAIC, evidence corroborating its overall survival (OS) benefits compared with standard treatments is insufficient. Nevertheless, HAIC may provide prominent benefits in selected patients such as patients with portal vein thrombosis or high intrahepatic tumor burden. Moreover, HAIC has been combined with several therapeutic agents and modalities, including interferon-alpha, multikinase inhibitors, radiation therapy, and immunotherapy, to augment its treatment efficacy. Most of these combinations appeared to increase overall response rates compared with HAIC alone, but results regarding OS are inconclusive. Two prospective randomized controlled trials comparing HAIC plus sorafenib with sorafenib alone have reported conflicting results, necessitating further research. As immunotherapy-based combinations became the mainstream treatments for advanced HCC, HAIC plus immunotherapy-based treatments also showed encouraging preliminary results. The trials of HAIC were heterogeneous in terms of patient selection, chemotherapy regimens and doses, HAIC combination agent selections, and HAIC technical protocols. These heterogeneities may contribute to differences in treatment efficacy, thus increasing the difficulty of interpreting trial results. We propose that future trials of HAIC standardize these key factors to reveal the clinical value of HAIC-based treatments for HCC.

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Comparison of clinical outcomes between sorafenib and hepatic artery infusion chemotherapy in advanced hepatocellular carcinoma

Medicine ◽

10.1097/md.0000000000010611 ◽

2018 ◽

Vol 97 (17) ◽

pp. e0611 ◽

Cited By ~ 1

Author(s):

Min Kyu Kang ◽

Jung Gil Park ◽

Heon Ju Lee

Keyword(s):

Hepatocellular Carcinoma ◽

Clinical Outcomes ◽

Hepatic Artery ◽

Hepatic Artery Infusion ◽

Advanced Hepatocellular Carcinoma ◽

Infusion Chemotherapy ◽

Hepatic Artery Infusion Chemotherapy

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Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Inhibitors Plus Lenvatinib Versus PD-1 Inhibitors Plus Lenvatinib for Advanced Hepatocellular Carcinoma

Frontiers in Oncology ◽

10.3389/fonc.2021.618206 ◽

2021 ◽

Vol 11 ◽

Author(s):

Jie Mei ◽

Yu-Hao Tang ◽

Wei Wei ◽

Ming Shi ◽

Lie Zheng ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatic Arterial Infusion ◽

Progression Free Survival ◽

Good Survival ◽

Hepatic Artery Infusion ◽

Advanced Hepatocellular Carcinoma ◽

Advanced Hcc ◽

Infusion Chemotherapy ◽

Hepatic Artery Infusion Chemotherapy ◽

Cell Death Protein

BackgroundLenvatinib combined with programmed cell death protein-1 (PD-1) inhibitors has resulted in good survival outcomes in the treatment of unresectable hepatocellular carcinoma (HCC). Hepatic artery infusion chemotherapy (HAIC) has also attracted attention due to its high response rates and favorable survival for advanced HCC patients. The present study aimed to compare the efficacy of HAIC combined with PD-1 inhibitors plus lenvatinib (HPL) and PD-1 inhibitors plus lenvatinib (PL) in patients with advanced HCC.MethodsBetween July 2018 and December 2019, patients diagnosed with advanced HCC who initially received HPL or PL treatment were reviewed for eligibility. Efficacy was evaluated according to tumor response and survival.ResultsIn total, 70 patients met the criteria and were included in the present study, and they were divided into the HPL group (n = 45) and PL group (n = 25). The overall response rate (40.0 vs. 16.0%, respectively; p = 0.038) and disease control rate (77.6 vs. 44.0%, respectively; p < 0.001) were higher in the HPL group than in the PL group. The median overall survival was 15.9 months in the HPL group and 8.6 months in the PL group (p = 0.0015; HR = 0.6; 95% CI 0.43–0.83). The median progression-free survival was 8.8 months in the HPL group and 5.4 months in the PL group (p = 0.0320; HR = 0.74; 95% CI 0.55–0.98).ConclusionCompared to PL, HPL was associated with a significantly better treatment response and survival benefits for patients with advanced HCC.

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