Hepatic arterial infusion chemotherapy combined with transcatheter chemoembolization, camrelizumab, and apatinib for BCLC stage C hepatocellular carcinoma: A retrospective study.

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Background: This study assessed the combination of hepatic arterial infusion chemotherapy (HAIC), transcatheter chemoembolization (TACE), camrelizumab, and apatinib in patients with BCLC stage C hepatocellular carcinoma (HCC). Methods: This retrospective study was approved by the Ethics Committee of the First Hospital of Jilin University. Patients were included if they had: (1) BCLC stage C HCC; (2) treatment between December 2023 and January 2026; (3) receipt of HAIC, TACE, camrelizumab, and apatinib; (4) complete treatment and follow-up records. The primary outcome was progression-free survival (PFS). Secondary outcomes included overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety. Results: Fifty-one patients were included: 84.3% male, 66.7% age < 65 years, 66.7% HBV, 13.7% HCV. PVTT distribution: Vp2 (11.8%), Vp3 (60.8%), Vp4 (27.5%). Extrahepatic metastases occurred in 17.6%; tumor diameter ≥7 cm in 54.9%. Child-Pugh A: 66.7%, B: 33.3%. CNLC stage IIIa: 80.4%, IIIb: 19.6%. Median PFS was 4.2 months (95% CI 2.5–7.9); median OS was 12.9 months (95% CI 8.9–NA). ORR was 43.1% and DCR 49.0% (22 partial responses, 3 stable disease). Grade ≥3 laboratory abnormalities related to interventional therapy included elevated ALT, elevated AST, anemia, and decreased white blood cell count; those related to systemic therapy included elevated ALT, elevated AST, elevated bilirubin, anemia, and decreased white blood cell count. No treatment-related deaths occurred. Conclusions: The combination of HAIC, TACE, camrelizumab, and apatinib showed encouraging efficacy and acceptable safety in BCLC stage C HCC. Prospective randomized trials are warranted.