An analysis on the clinical efficacy and prognosis of sintilimab combined with TACE in the treatment of postoperative unresectable intrahepatic metastases of hepatocellular carcinoma

Abstract

Abstract: Objective This study aimed to evaluate the clinical efficacy and prognosis of sintilimab combined with transarterial chemoembolization (TACE) treatments on patients with unresectable intrahepatic metastases of hepatocellular carcinoma (HCC) after surgery. Methods A prospective study was conducted on 80 patients collected from January 2017 to December 2022 with unresectable intrahepatic metastatic HCC following surgical resection. All patients were randomly assigned to either the combination group (sintilimab plus TACE, n=40) or the monotherapy group (TACE alone, n=40). The clinical efficacy, serum tumor markers, immune indices, and adverse event incidence were compared between the two groups. A survival analysis was also performed. Results After treatment, the objective response rate (ORR) (52.50% vs. 25.00%) and disease control rate (DCR) (92.50% vs. 72.50%) were significantly higher in the combination group than those in the monotherapy group (P<0.05). The combination group exhibited significantly lower levels of cancer antigen 125 (CA125) [(28.47±3.23) U/mL vs. (39.16±4.79) U/mL] and alpha-fetoprotein (AFP) [(403.85±32.79) ng/mL vs. (513.85±47.93) ng/mL], as well as higher levels of CD3⁺ [(70.14±7.03)% vs. (64.85±5.14)%] and CD4⁺/CD8⁺ ratio [(1.78±0.51) vs. (1.47±0.54)] compared to the monotherapy group (P<0.05). The incidence rates of adverse events, including liver dysfunction (22.5% vs. 25.00%), fatigue (50.00% vs. 52.50%), fever (7.50% vs. 8.00%), and leukopenia (32.50% vs. 35.00%), showed no significant differences between the two groups (P>0.05). Kaplan-Meier survival analysis revealed that the combination group had a longer median overall survival (OS) (21.6 months vs. 19.1 months) and median progression-free survival (PFS) (17.4 months vs. 11.8 months) compared to the monotherapy group (P<0.05). Conclusion The combination of sintilimab and TACE significantly improves therapeutic efficacy, enhances immune function, and prolongs OS and PFS in patients with HCC without increasing severe adverse events, demonstrating favorable clinical application potential.

Key words: Hepatocellular carcinoma, Sintilimab, Transarterial chemoembolization, Clinical efficacy, Prognostic analysis

HU Jin-ting, SUN Xin-xin, ZUO Chuan-wei. An analysis on the clinical efficacy and prognosis of sintilimab combined with TACE in the treatment of postoperative unresectable intrahepatic metastases of hepatocellular carcinoma[J]. Chinese Hepatolgy, 2025, 30(10): 1344-1348.

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