Evaluation of the efficacy of aparatinib and carrilizumab combined with transcatheter arterial chemoembolization in the treatment of primary hepatocellular carcinoma

OBJECTIVE: The study aimed to analyze the efficacy of aparatinib and carrilizum-ab combined with transcatheter arterial chemo-embolization (TACE) in the treatment of primary hepatocellular carcinoma (HCC).PATIENTS AND METHODS: A total of 150 pa-tients with primary HCC admitted to our hospi-tal from March 1, 2019, to March 1, 2022 was cho-sen and randomized as the control and treat-ment group. The control group went through TACE treatment, and the treatment group experienced apatinib + karilizumab + TACE treatment. The near and long-term efficacy of the two groups were compared. The total survival time (OS), time to progression (TTP), and hospital costs were com-pared between the two groups. Fasting venous blood was collected before and one month after treatment in the two groups, and liver and kidney functions were tested using automatic biochemi-cal analyzer. The levels of CD3+, CD4+ and CD8+ were detected by flow cytometry, and CD4+/CD8+ was calculated. The levels of cysteinyl aspartate specific protease-8 (Caspase-8), vascular endo-thelial growth factor (VEGF) and alpha fetopro-tein (AFP) were detected by enzyme-linked immu-nosorbent assay (ELISA). The patients' conditions were closely observed and the adverse reaction rates of diarrhea, hand foot syndrome, bone mar-row suppression, proteinuria, fever and pain were compared between the two groups. RESULTS: The disease control rate (DCR) of short-term treatment in the treatment group was 97.33%, which was much higher than 88.00% in the control group. The survival ratios of the treat-ment group in September and December were 65.33% and 42.67% respectively, which were also much higher than 48.00% and 20.00% in the con-trol group (p < 0.05). The TTP and OS of patients in the treatment group were significantly longer than those in the control group (p < 0.05), and the hospital expenses were significantly higher than those in the control group (p < 0.05). The levels of liver function indicators such as alanine ami-notransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL) were largely de-creased in both groups after treatment, and more significant difference was detected in the treat-ment group (p < 0.05). Renal function between the two groups had no significant difference af-ter treatment (p > 0.05). After treatment, the levels AFP and VEGF were strongly decreased and the level of Caspase-8 was markedly increased in both groups, and the treatment group had lower levels of AFP and VEGF and higher level of Caspase-8 than the control group (p < 0.05). The CD3+ and CD4+/CD8+ levels in two groups were dramatically elevated after treatment, and the treatment group had much higher CD3+ and CD4+/CD8+ levels than the control group (p < 0.05). There was no statistically significant differ-ence in the rates of adverse reactions such as di-arrhea, hand-foot syndrome, bone marrow sup-pression, proteinuria, fever, and pain between the two groups (p > 0.05).CONCLUSIONS: The combination of apati-nib and carrilizumab with TACE had better near -and long-term efficacy in the treatment of pri-mary HCC by effectively inhibiting tumor vascu-lar regeneration, inducing tumor cell apoptosis, and improving patients' liver function and im-mune function with higher safety, which could be widely used in clinical practice.