Treatment with a combination of hepatic arterial infusion chemotherapy with anti-PD-1 immunotherapy and tyrosine kinase inhibitors is safe and effective in patients with unresectable intrahepatic cholangiocarcinoma, according to a new study published in the Journal of Digestive Diseases.

The size of the tumor may be a significant factor in the response rate after treatment, the authors said. The researchers added that they were considering testing this combination therapy in a randomized clinical trial.

In the present study, they compared the therapeutic effect and toxicity of hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy with that of transarterial chemoembolization combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy.


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They compared the clinicopathological characteristics, treatment efficacy, and adverse events between the 2 combinations. They also analyzed factors associated with the response rate.

A total of 58 patients were enrolled in the study with 39 enrolled in the first group and 19 enrolled in the second group. Patients who received hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy showed a better objective response rate compared to the others. This treatment combination also resulted in a better disease control rate. 

However, these patients did not reach the median progression-free survival length and the 1-year progression-free survival rate was 61.9%. 

In comparison, the median progression-free survival in patients treated with transarterial chemoembolization combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy was 11 months and their 1-year progression-free survival rate was 31.6%. 

Factors affecting the response rate were the type of treatment and the size of the tumor. 

More patients receiving hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy had a rash, abdominal pain, and hand and foot syndrome. However, all adverse events were acceptable, and the researchers reported no treatment-related deaths.

Reference

Zhang N, Yu B, Wang Y, et al. Clinical outcomes of hepatic arterial infusion chemotherapy combined with tyrosine kinase inhibitors and anti-PD-1 immunotherapy for unresectable intrahepatic cholangiocarcinoma. J Dig Dis. Published online September 22, 2022. doi:10.1111/1751-2980.13127