Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis
Xuefeng Kan, Bin Liang, Guofeng Zhou, Bin Xiong, Feng Pan, Yanqiao Ren, Yanyan Cao, Jihua Wang, Fan Yang, Chuansheng Zheng
Abstract
Background: Apatinib is a powerful inhibitor of vascular endothelial growth factor receptor-2. This study was to investigate whether apatinib could improve the efficacy of transarterial chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC). Methods: Between June 2015 and September 2018, 357 patients with HCC at Barcelona Clinic Liver Cancer stage C who received the treatment of TACE combining with apatinib (TACE-apatinib) or TACE-alone were included. Propensity score matching (PSM) analysis was used to reduce the patient selection bias. Results: Ninety pairs of patients were chosen after PSM analysis. The disease control rates of tumor and a-fetoprotein response in the TACE-apatinib group were significantly higher than that of the TACE-alone group before and after PSM analysis (P<0.05). Before PSM analysis, the median time of progression (TTP) and overall survival (OS) in the TACE-apatinib group was significantly greater than that of the TACE-alone group (TTP: 9.0 months versus 3.0 months, P<0.001; OS: 14.0 months versus 7.0 months, P<0.001 ). After PSM analysis, the median TTP and OS in the TACE-apatinib group was also significantly greater than that of the TACE-alone group (TTP: 7.0 months versus 3.0 months, P<0.001; OS: 13.0 months versus 8.0 months, P<0.001); the uni- and multivariate analysis revealed that TACE-apatinib was a protective factor for OS. Fourteen patients emerged with grade 3 apatinib-related adverse events. Conclusion: The efficacy of TACE-apatinib for patients with advanced HCC was inspiring, and the side effects of apatinib were tolerable.