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Effect of camrelizumab plus transarterial chemoembolization on massive hepatocellular carcinoma - 28/05/22

Doi : 10.1016/j.clinre.2021.101851 
Sujing Zhang 1, Yingchun Zhao 1, Li He, Changwen Bo, Yonghui An, Na Li, Wenhua Ma, Ying Guo, Yan Guo, Changwang Zhang
 Department of Oncology, The First Hospital of Hebei Medical University, Shijiazhuang, China 

Corresponding author.

Highlight

Camrelizumab combined with TACE treatment significantly improve the liver function of patients with massive HCC
improve the treatment effect, which is worthy of clinical promotion.
Camrelizumab combined with TACE reduce the levels of AFP, CEA and CA19-9 in patients with massive HCC

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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.

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


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Vol 46 - N° 4

Article 101851- avril 2022 Retour au numéro
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