Safety and Efficacy of Adebrelimab plus Apatinib Combined with Hepatic Artery Infusion Chemotherapy for the Treatment of Unresectable Hepatocellular Carcinoma: A Retrospective Study

Abstract

The combined therapy of immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) is now an approved first-line approach for unresectable hepatocellular carcinoma (HCC). Hepatic arterial infusion chemotherapy (HAIC) with the FOLFOX regimen (oxaliplatin, fluorouracil, and leucovorin) has also shown promising outcomes for advanced HCC. However, the efficacy of these two therapeutic strategies remains to be further improved. This retrospective study evaluated the safety and the efficacy of combining adebrelimab (a PD-L1 inhibitor), apatinib (a TKI), and FOLFOX-HAIC for unresectable HCC. The medical records of unresectable HCC patients who received adebrelimab, apatinib, and FOLFOX-HAIC from March 2023 to November 2023 at the First Affiliated Hospital of Sun Yat-sen University (FAH-SYSU) were retrospectively reviewed. Safety was assessed by the frequency and severity of adverse events (AEs), and efficacy was evaluated by tumor response criteria including objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). A total of 19 patients were enrolled. There was no treatment-related death. The most frequent grade ≥ 3 treatment-related AEs were increased ALT/AST (47.4%) and thrombocytopenia (15.8%). The ORR was 26.3% and 57.9% as per RECIST 1.1 and mRECIST, respectively. The DCR was 84.2% and 89.5% as per RECIST 1.1 and mRECIST, respectively. The median PFS was 9.0 months by both RECIST 1.1 and mRECIST, and median OS was 22.0 months. The combination of adebrelimab, apatinib, and FOLFOX-HAIC showed manageable safety and encouraging efficacy for unresectable HCC. This regimen may represent a novel therapeutic option for advanced HCC and warrants further investigation.