PMID- 36920551 OWN - NLM STAT- MEDLINE DCOM- 20230529 LR - 20230814 IS - 2155-384X (Electronic) IS - 2155-384X (Linking) VI - 14 IP - 5 DP - 2023 May 1 TI - Transarterial Chemoembolization Combined With Apatinib Plus PD-1 Inhibitors for Hepatocellular Carcinoma With Portal Vein Tumor Thrombus: A Multicenter Retrospective Study. PG - e00581 LID - 10.14309/ctg.0000000000000581 [doi] LID - e00581 AB - INTRODUCTION: The aim of this study was to compare transarterial chemoembolization (TACE) combined with apatinib and PD-1 inhibitors (TACE-AP) with TACE combined with apatinib alone (TACE-A) in the treatment of hepatocellular carcinoma (HCC) with portal vein tumor thrombus (PVTT) and to explore the prognostic factors affecting the survival of patients. METHODS: This retrospective study analyzed data of patients with HCC with PVTT who were treated with TACE-AP or TACE-A between December 2018 and June 2021. The primary end points of the study were progression-free survival (PFS) and overall survival (OS), and the secondary end points were objective response rate (ORR) and adverse events (AEs). Propensity score matching (PSM) and stabilized inverse probability weighting (sIPTW) analyses were used to reduce patient selection bias, and Cox regression analysis was used to analyze prognostic factors affecting patient survival. RESULTS: Sixty-nine and 40 patients were included in the TACE-A and TACE-AP groups, respectively. After PSM and IPTW analyses, the median PFS and median OS in the TACE-AP group were significantly higher than those in the TACE-A group (PFS: after PSM, 6.9 vs 4.0 months, P < 0.001, after IPTW, 6.5 vs 5.1 months, P < 0.001; OS: after PSM, 14.6 vs 8.5 months P < 0.001, after IPTW, 16.1 vs 10.5 months, P < 0.001). After PSM and IPTW analyses, the tumor ORR in the TACE-AP group was significantly higher than that in the TACE-A group (PSM, 53.6% vs 17.9%, P = 0.005; IPTW, 52.5% vs 28.6%, P = 0.013). All treatment-related AEs were observed to be tolerated. Multivariate Cox regression analysis showed that the main prognostic factors affecting the survival of patients were tumor number, PVTT type, alpha-fetoprotein, and treatment mode. DISCUSSION: In the treatment of patients with HCC with PVTT, TACE-AP significantly improved PFS, OS, and ORR, and the AEs were safe and controllable. CI - Copyright (c) 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology. FAU - Xia, Wei-Li AU - Xia WL AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. FAU - Zhao, Xiao-Hui AU - Zhao XH AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. FAU - Guo, Yuan AU - Guo Y AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. FAU - Hu, Hong-Tao AU - Hu HT AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. FAU - Cao, Guang-Shao AU - Cao GS AD - Department of Intervention, Henan Provincial People's Hospital, Zhengzhou, China. FAU - Li, Zhen AU - Li Z AD - Department of Interventional Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. FAU - Fan, Wei-Jun AU - Fan WJ AD - Department of Minimally Invasive Interventional Radiology, Sun Yat-sen University Cancer Center, Guangzhou, China. FAU - Xu, Shi-Jun AU - Xu SJ AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. FAU - Li, Hai-Liang AU - Li HL AD - Department of Minimal-Invasive Intervention, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China. LA - eng PT - Journal Article PT - Multicenter Study DEP - 20230501 PL - United States TA - Clin Transl Gastroenterol JT - Clinical and translational gastroenterology JID - 101532142 RN - 5S371K6132 (apatinib) RN - 0 (Immune Checkpoint Inhibitors) SB - IM MH - Humans MH - *Carcinoma, Hepatocellular/pathology MH - *Liver Neoplasms/pathology MH - Retrospective Studies MH - Immune Checkpoint Inhibitors/therapeutic use MH - Portal Vein/pathology MH - *Chemoembolization, Therapeutic/adverse effects MH - Treatment Outcome MH - *Thrombosis PMC - PMC10208716 COIS- Guarantor of the article: Specific author contributions: H.-L.L., H.-T.H., and S.-J.X.: conception and design the study. W.-L.X., G.-S.C., Z.L., and W.-J.F.: provision of study materials or patients. W.-L.X., Y.G., X.-H.Z., and S.-J.X.: collection and assembly of data. X.-H.Z. and Y.G.: data analysis and interpretation. W.-L.X.: manuscript writing. H.-L.L., H.-T.H., and S.-J.X.: manuscript reviewing. All authors: final approval of manuscript. Financial support: This work was supported by The National Natural Science Foundation (82002596), Henan Province Natural Science Foundation (212300410403), Medical Science and Technology Research Project of Henan Province (No. LHGJ20190633), Science and Technology Department of Henan Province (No. 212102310162), Beijing Health Alliance Charitable Foundation (HN-20201017-001), and the Technology Major Project of the Ministry of Science and Technology of China (2018ZX10303502). Potential competing interests: None to report. EDAT- 2023/03/16 06:00 MHDA- 2023/05/29 06:42 PMCR- 2023/03/15 CRDT- 2023/03/15 12:16 PHST- 2022/12/07 00:00 [received] PHST- 2023/02/17 00:00 [accepted] PHST- 2023/05/29 06:42 [medline] PHST- 2023/03/16 06:00 [pubmed] PHST- 2023/03/15 12:16 [entrez] PHST- 2023/03/15 00:00 [pmc-release] AID - 01720094-202305000-00005 [pii] AID - CTG-22-0398 [pii] AID - 10.14309/ctg.0000000000000581 [doi] PST - epublish SO - Clin Transl Gastroenterol. 2023 May 1;14(5):e00581. doi: 10.14309/ctg.0000000000000581.