202P - Comparison of liver injury after transcatheter arterial chemoembolization and hepatic arterial infusion chemotherapy for intermediate and advanced hepatocellular carcinoma

Background

Interventional therapy is the main treatment for intermediate and advanced hepatocellular carcinoma (HCC) and liver injury is one of the common adverse effects after interventional therapy. This study aimed to compare the liver injury after transcatheter arterial chemoembolization (TACE) combined with immune checkpoint inhibitors (ICIs) and tyrosine kinase inhibitors (TKIs) and hepatic arterial infusion chemotherapy (HAIC) combined with ICIs and TKIs for intermediate and advanced HCC.

Methods

We retrospectively enrolled patients with intermediate and advanced HCC who received TACE/HAIC combined with ICIs and TKIs from January 2019 to November 2021, in Nanfang Hospital. The liver function indexs within 1 week before treatment and on the first day after intervention were recorded. The degree of postoperative liver injury was assessed according to the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE 5.0).

Results

82 patients were treated with HAIC combined with ICIs and TKIs and another 77 patients received TACE combined with ICIs and TKIs. There were no significant differences in gender, age, cirrhosis, Child-Pugh grade, ALBI grade and combined ICIs and TKIs regimen at baseline between the two groups. The patients had more advanced tumor stage, heavier tumor load, and poorer liver reserve function in the HAIC group. Patients who underwent HAIC had larger proportion of BCLC stage C HCC（81.7% vs 63.6%，p=0.01）,greater percentage of tumor with a maximum diameter greater than or equal to 10 centimeters（64.6% vs 32.5%，p<0.001）than patients in the TACE group. The frequencies of elevated ALT (28.0% vs 63.6%; P<0.001), elevated AST (54.9% vs 85.7%; p<0.001), and hyperbilirubinemia (40.2% vs 55.8%，p=0.049) were significantly lower in the HAIC group than in the TACE group. There were more patients having ALBI score of grade III after therapy in the TACE group than in the HAIC group(16.9% vs 6.1%，p=0.032). The effectiveness of HAIC with ICIs and TKIs were comparable to TACE with ICIs and TKIs.

Conclusions

The incidence of liver injury events was higher in the TACE group than in the HAIC group.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.