Efficacy and safety of transcatheter arterial chemoembolization combined with sorafenib and sintilimab in the treatment of unresectable hepatocellular carcinoma

Objective: To investigate the efficacy and safety of transcatheter arterial chemoembolization (TACE) combined with sorafenib and sintilimab in the treatment of unresectable hepatocellular carcinoma (HCC).

Method: This study retrospectively analyzed the clinical data from 50 patients with unresectable HCC treated at Yunhe County People's Hospital of Zhejiang Province from January 2023 to December 2023. The patients were divided into two groups according to treatment regimen: a control group (n=20) treated with TACE alone, and a combination group (n=30) treated with TACE combined with sorafenib and sintilimab. Baseline data, changes in hematological parameters before and after treatment, objective response rate (ORR), disease control rate (DCR), and prognosis were compared between the two groups. Besides, the progression-free survival (PFS) and overall survival (OS) time were also compared between the two groups.

Result: The combination group demonstrated significantly lower AFP levels compared to the control group (789.44±23.55 ng/l vs. 1244.65±36.85 ng/l, P<0.05). The ORR and DCR of the combination group were notably higher than those of the control group (56.67% vs. 25.00%, P<0.05; 83.33% vs. 55.00%, P<0.05, respectively). The median PFS and OS of the combined group were significantly longer than those of the control group (12.86 months vs. 5.72 months, P=0.007; 15.63 months vs. 7.05 months, P=0.001, respectively). Moreover, there were no significant differences in grade 1-2 adverse events between the two groups, while the incidence of grade 3 adverse events was significantly lower in the combination group compared to the control group (P<0.05).

Conclusion: Our results suggest that the combination of TACE with sorafenib and sintilimab is a feasible treatment option for patients with unresectable HCC, with high efficacy and reasonable safety.