Comparison of the efficacy and safety of Transarterial chemoembolization with and without Apatinib for the treatment of BCLC stage C hepatocellular carcinoma

BackgroundHepatocellular carcinoma (HCC) is a common cancer worldwide, with a poor prognosis. Most patients are diagnosed at advanced stages and are only eligible for palliative therapy. Therefore, this study aimed to evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) combined with apatinib (TACE-apatinib) treatment and TACE-alone treatment for Barcelona Clinic Liver Cancer stage C HCC.MethodsWe retrospectively reviewed 80 consecutive patients with BCLC stage C HCC who received TACE-apatinib or TACE-alone as the initial treatment. We compared the clinical and laboratory outcomes, imaging findings at 1 and 3months after TACE, tumor response, time to progression (TTP), overall survival (OS), and adverse events between both groups.ResultsThe overall response rate was higher in the TACE-apatinib group than in the TACE-alone group at 1 and 3months after treatment (66.7% vs 39.6%, respectively, P=0.020; 45.8% vs 17.6%, respectively, P=0.021). The median TTP and OS in the TACE-apatinib group were longer than those of the TACE-alone group (TTP: 6.3months vs 3.5months, respectively, P=0.002; OS: 13.0months vs 9.9months, respectively, P=0.041). Apatinib-associated side effects such as hypertension, hand-foot syndrome, oral ulcers, proteinuria, and diarrhea were more prevalent in the TACE-apatinib group than in TACE-alone group (P<0.05).ConclusionCompared to TACE-alone treatment, TACE-apatinib increased the TTP, OS, and tumor-response rate at 1 and 3months after treatment of BCLC stage C HCC without any significant increase in severe adverse events.