Xin Zheng,1 Kun Qian2,3 

1Department of Hepatopancreatobiliary Surgery, The First College of Clinical Medical Science, China Three Gorges University & Yichang Central People’s Hospital, Yichang, People’s Republic of China; 2Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China; 3Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, 430022, People’s Republic of China

Correspondence: Kun Qian, Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People’s Republic of China, Email kunchien@163.com

Background: This study aimed to assess the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with apatinib and camrelizumab in patients with recurrent hepatocellular carcinoma (HCC) following hepatectomy.
Methods: From July 2020 to December 2024, consecutive medical records of recurrent HCC patients treated with HAIC plus apatinib/camrelizumab were retrospectively reviewed. Key outcomes, including overall survival (OS), progression-free survival (PFS), therapeutic response, and treatment-related complications, were evaluated.
Results: The study was followed up until January 31, 2025, with a median follow-up duration of 11 months (range: 2– 26 months). Among the 110 eligible recurrent HCC patients (91 males and 19 females), 62 deaths were recorded. The objective response rate (ORR) was 31.8%, and the disease control rate (DCR) was 87.3%. The median OS was 14 months (95% CI: 12.9– 15.1 months), with multivariable analysis identifying vascular invasion as an independent prognostic factor for OS. The median PFS was 7 months (95% CI: 5.3– 8.7 months), and the platelet-to-lymphocyte ratio was found to be an independent prognostic factor for PFS. All adverse events were manageable, and no treatment-related deaths occurred.
Conclusion: HAIC combined with apatinib/camrelizumab is effective and safe in the treatment of recurrent HCC after hepatectomy, which may be a promising treatment for recurrent HCC.

Keywords: hepatic arterial infusion chemotherapy, apatinib, camrelizumab, hepatocellular carcinoma, recurrent