Apatinib plus hepatic arterial infusion of oxaliplatin and raltitrexed for hepatocellular carcinoma with extrahepatic metastasis: phase II trial

Shiguang Chen, Xiangdong Wang, Bo Yuan, Jianyang Peng, Qingxian Zhang, Wenchang Yu, Naijian Ge, Zhicheng Weng, Jinqi Huang, Weifu Liu, Xiaolong Wang and Chuanben Chen ()
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Shiguang Chen: Fujian Cancer Hospital
Xiangdong Wang: Second Military Medical University/ Navy Medical University
Bo Yuan: Xuzhou Central Hospital
Jianyang Peng: Affiliated Hospital of Putian University
Qingxian Zhang: the First Hospital of Putian City
Wenchang Yu: Fujian Cancer Hospital
Naijian Ge: Second Military Medical University/ Navy Medical University
Zhicheng Weng: Affiliated Hospital of Putian University
Jinqi Huang: the First Hospital of Putian City
Weifu Liu: Fujian Cancer Hospital
Xiaolong Wang: Fujian Cancer Hospital
Chuanben Chen: Fujian Cancer Hospital

Nature Communications, 2024, vol. 15, issue 1, 1-10

Abstract: Abstract Most patients with advanced hepatocellular carcinoma (HCC) ultimately experience tumor progression after first-line systemic therapies. Systemic therapy is generally recommended as second-line treatment for advanced HCC in the major guidelines. Combining apatinib with hepatic arterial infusion chemotherapy (HAIC) likely drives synergistic activity on advanced HCC with extrahepatic metastasis. This phase II trial (ChiCTR2000029082) aimed to assess efficacy and safety of this combination in patients with HCC with extrahepatic metastasis who have progressed after first-line systemic therapies. The primary end point was the objective response rate (ORR). The secondary endpoints were progress-free survival (PFS), disease control rate (DCR), 6- and 12-month survival rates, overall survival (OS), and adverse events (AEs). Thirty-nine patients received oral treatment with apatinib, and hepatic artery infusion oxaliplatinplus raltitrexed. Per RECIST v1.1, the ORR and DCR was 53.8% and 89.7% in the patients population, respectively. The median PFS and OS was 6.2 months and 11.3 months, respectively. The 6- and 12-month survival rates were 81.7% and 44.1%, respectively. All AEs were manageable by medication or dose modifications. Apatinib plus HAIC for second-line therapy in advanced HCC with extrahepatic metastasis shows promising efficacy and manageable toxicities.

Date: 2024
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DOI: 10.1038/s41467-024-52700-z

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