The safety and efficacy of transarterial chemoembolization plus molecular targeted therapy (MTT) combined with immune checkpoint inhibitors (ICIs) in primary liver cancer have been demonstrated. However, the evidence for TACE plus MTT combined with ICIs in the treatment of recurrent hepatocellular carcinoma (RHCC) is limited. Given the excellent performance of this combination regimen in primary liver cancer, it is necessary to evaluate the efficacy of TACE plus MTT combined with ICIs in RHCC. A total of 88 patients with RHCC treated with TACE plus MTT combined with camrelizumab (TACE-TC group, n = 46) or TACE plus MTT (TACE-T group, n = 42) were retrospectively collected and analyzed. In this study, we evaluated the effectiveness and safety of combination therapy for patients with RHCC by analyzing tumor response, progression-free survival (PFS), overall survival (OS), laboratory biochemical indices, and adverse events (AEs). TACE-TC was superior to TACE-T in PFS (14.0 vs. 8.9 months, p = 0.034) and OS (31.1 vs. 20.2 months, p = 0.009). Moreover, TACE-TC achieved more preferable benefits with respect to disease control rate (89.1% vs. 71.4%, p = 0.036) and objective response rate (47.8% vs. 26.2%, p = 0.036) compared with TACE-T in patients with RHCC. Compared with the TACE-T group, the AFP level in the TACE-TC group decreased more significantly after 3 months of treatment. Multivariate analysis showed that treatment option was a significant predictor of OS and PFS, while the portal vein tumor thrombus and interval of recurrence from initial treatment were another prognostic factor of PFS. There was no significant difference between the TACE-TC and TACE-T groups for Grade 3–4 adverse events. A combination therapy of TACE, MTT, and camrelizumab significantly improved tumor response and prolonged survival duration, showing a better survival prognosis for RHCC patients.

中文翻译：

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分子靶向治疗联合卡瑞珠单抗经动脉化疗栓塞治疗复发性肝细胞癌

经动脉化疗栓塞联合分子靶向治疗（MTT）联合免疫检查点抑制剂（ICIs）治疗原发性肝癌的安全性和有效性已得到证实。然而，TACE加MTT联合ICIs治疗复发性肝细胞癌（RHCC）的证据有限。鉴于该联合方案在原发性肝癌中的优异表现，有必要评估TACE加MTT联合ICIs治疗RHCC的疗效。回顾性收集并分析88例接受TACE联合MTT联合卡瑞利珠单抗（TACE-TC组，n = 46）或TACE联合MTT（TACE-T组，n = 42）治疗的RHCC患者。在本研究中，我们通过分析肿瘤反应、无进展生存期（PFS）、总生存期（OS）、实验室生化指标和不良事件（AE）来评估联合治疗对 RHCC 患者的有效性和安全性。 TACE-TC 在 PFS（14.0 个月与 8.9 个月，p = 0.034）和 OS（31.1 个月与 20.2 个月，p = 0.009）方面优于 TACE-T。此外，与 TACE-T 相比，TACE-TC 在疾病控制率（89.1% vs. 71.4%，p = 0.036）和客观缓解率（47.8% vs. 26.2%，p = 0.036）方面取得了更好的效果与 RHCC。与TACE-T组相比，治疗3个月后TACE-TC组AFP水平下降更为明显。多变量分析显示，治疗选择是 OS 和 PFS 的重要预测因素，而门静脉癌栓和距初始治疗的复发间隔是 PFS 的另一个预后因素。 TACE-TC 组和 TACE-T 组之间 3-4 级不良事件没有显着差异。 TACE、MTT 和卡瑞利珠单抗的联合治疗显着改善了肿瘤反应并延长了生存期，显示 RHCC 患者更好的生存预后。