Efficacy And Prognosis Of Camrelizumab Combined With Apatinib In The Treatment Of Advanced Hepatocellular Carcinoma

Objective: To investigate the efficacy and prognosis of camrelizumab combined with apatinib in the treatment of advanced hepatocellular carcinoma.Methods: A total of 117 patients with advanced HCC were admitted to the first affiliated Hospital of Xinjiang Medical University between June 2019 and October 2021 were retrospectively analyzed.They were divided into two groups: camrelizumab combined with apatinib group(combined treatment group,n = 65)and apatinib group(n = 52).The clinical data,laboratory examination and clinical efficacy of the two groups before and after treatment were compared.The therapeutic effect of tumor was evaluated according to m RECIST.The progression-free survival(PFS)and univariate analysis of prognosis were analyzed by Kaplan-Meier method,and the prognostic factors of PFS were analyzed by multivariate COX regression model.Results: All patients were treated for 12 months,the objective remission rate(ORR)and disease control rate(DCR)in the combined treatment group were 44.7% and 66.2%,both significantly higher than 15.4% and 42.3% in the apatinib group(P < 0.05).And serum alpha-fetoprotein level decreased significantly after treatment(P < 0.05).Compared with apatinib group,platelet(PLT),total bilirubin(TBIL)and alanine aminotransferase(ALT)in combined treatment group decreased significantly(P < 0.05).The PFS of the combined treatment group was 10.6 months(95%CI: 9.986 ～11.16),and the apatinib group was 7.9 months(95%CI: 6.84 ～ 8.944).There was significant difference in PFS between the two groups(P < 0.05).Kaplan-Meier survival analysis showed that performance status(PS),Child-Pugh score,CNLC stage,liver cirrhosis,portal vein tumor thrombus and transarterial chemoembolization(TACE)were the prognostic factors of PFS(P < 0.05).Multivariate COX regression model analysis showed that Child-Pugh grade B(HR = 2.379,95%CI: 1.14 ～ 4.964,P = 0.021)and portal vein tumor thrombus(HR = 3.481,95%CI: 1.536 ～ 7.889,P = 0.003)were independent risk factors for PFS in patients with advanced HCC.While TACE(HR = 0.528,95%CI:0.293 ～ 0.952,P = 0.034)was an independent protective factor for PFS in patients with advanced HCC.Conclusion: Camrelizumab combined with apatinib can effectively improve the curative effect,reduce serum alpha-fetoprotein level,improve liver function and prolong survival time in patients with advanced HCC.For patients with high tumor load,TACE combined with apatinib and camrelizumab can provide better clinical benefits.