The worthy role of hepatic arterial infusion chemotherapy in combination with anti-programmed cell death protein 1 monoclonal antibody immunotherapy in advanced hepatocellular carcinoma

Sep 24, 2026

The review evaluates hepatic arterial infusion chemotherapy (HAIC) combined with anti-programmed cell death protein 1 (anti-PD-1) monoclonal antibody immunotherapy for advanced hepatocellular carcinoma (HCC). It addresses why systemic therapy alone often yields limited intrahepatic control and outlines how HAIC can enhance local tumor management while retaining systemic antitumor effects. The paper synthesizes available clinical evidence on effectiveness, safety, applicability, and the molecular mechanisms for HAIC-sensitizing immunotherapy, with emphasis on patients including those with portal vein tumor thrombosis.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages13

Reading Time33 min

AccessFree to download

Introduction

Current treatment challenges in advanced HCC

Rationale for combining local and systemic therapy

Regimens and technique of HAIC

Chemotherapeutic agents used in HAIC

Epirubicin-HAIC regimen

TYPE Review PUBLISHED 31 October 2023 DOI 10.3389/fimmu.2023.1284937 OPEN ACCESS EDITED BY Tian Yang, Eastern Hepatobiliary Surgery Hospital, China REVIEWED BY Bahare Shokouhian, Royan Institute for Stem Cell Biology and Technology (RI-SCBT), Iran Nanya Wang, First Afﬁliated Hospital of Jilin University, China Hong Zhu, The First Afﬁliated Hospital of Soochow University, China *CORRESPONDENCE Jing Lv [lvjing922@126.com](lvjing922@126.com)[ ](lvjing922@126.com)Weiwei Qi [qwwdz@qdu.edu.cn](qwwdz@qdu.edu.cn) †These authors have contributed equally to this work RECEIVED 29 August 2023 ACCEPTED 19 October 2023 PUBLISHED 31 October 2023 CITATION Ding Y, Wang S, Qiu Z, Zhu C, Wang Y, Zhao S, Qiu W, Wang K, Lv J and Qi W (2023) The worthy role of hepatic arterial infusion chemotherapy in combination with anti-programmed cell death protein 1 monoclonal antibody immunotherapy in advanced hepatocellular carcinoma. Front. Immunol. 14:1284937 . doi: 10.3389/fimmu.2023.1284937 COPYRIGHT © 2023 Ding, Wang, Qiu, Zhu, Wang, Zhao, Qiu, Wang, Lv and Qi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. The worthy role of hepatic arterial infusion chemotherapy in combination with antiprogrammed cell death protein 1 monoclonal antibody immunotherapy in advanced hepatocellular carcinoma Yixin Ding 1†, Shasha Wang 1†, Zhenkang Qiu 2, Chunyang Zhu 1, Yan Wang 1, Shufen Zhao 1, Wensheng Qiu 1, Kongjia Wang 3, Jing Lv 1* and Weiwei Qi 1* 1 Department of Oncology, The Afﬁliated Hospital of Qingdao University, Qingdao University, Qingdao, China, 2 Interventional Medical Center, The Afﬁliated Hospital of Qingdao University, Qingdao, China, 3Qingdao Municipal Hospital, Qingdao University, Qingdao, China Systemic therapy remains the primary therapeutic approach for advanced hepatocellular carcinoma (HCC) . Nonetheless, its efﬁcacy in achieving control of intrahepatic lesions is constrained. Hepatic arterial infusion chemotherapy (HAIC) is a therapeutic approach that combines localized treatment with systemic antitumor effects, which aim is to effectively manage the progression of cancerous lesions within the liver, particularly in patients with portal vein tumor thrombosis (PVTT) . Combining HAIC with anti-programmed cell death protein 1 (anti-PD-1) monoclonal antibody (mAb) immunotherapy is anticipated to emerge as a novel therapeutic approach aimed at augmenting the response inside the localized tumor site and achieving prolonged survival advantages. In order to assess the effectiveness, safety, and applicability of various therapeutic modalities and to address potential molecular mechanisms underlying the efﬁcacy of HAIC-sensitizing immunotherapy, we reviewed the literature about the combination of HAIC with anti-PD-1 mAb therapies. KEYWORDS HAIC, anti-PD-1, immunotherapy, HCC, combined therapy Frontiers in Immunology 01 [frontiersin.org](frontiersin.org) 1 Introduction Primary liver cancer is a signiﬁcant cause of death globally, occupying the third position among cancer-related mortalities. Hepatocellular carcinoma (HCC) is the predominant pathological form with the 5-year survival rate ranging from 12.1% to 19%(1–5) . Around half of the patients who are diagnosed with advanced HCCare recommended to undergo systemic therapy (6) . Currently, thereis ongoing controversy among mainstream treatment guidelines worldwide over the optimal ﬁrst-line treatment for advanced HCC. American and European liver disease guidelines recommend targeted drugs and anti-PD-1 mAb monoclonal antibody drugs as adv

FAQs

Why is systemic therapy alone often insufficient for advanced hepatocellular carcinoma?

The review notes that systemic therapy can achieve only modest improvements in overall survival and may not adequately control intrahepatic lesions, especially when tumors have high burden and vascular invasion.

What is the therapeutic rationale for combining HAIC with anti-PD-1 immunotherapy?

HAIC is described as a localized interventional approach that can still exert systemic antitumor effects; combining it with anti-PD-1 aims to increase responses at the tumor site and support prolonged survival.

What aspects does the review cover regarding the HAIC plus anti-PD-1 combination?

It focuses on effectiveness, safety, applicability of different modalities and discusses potential molecular mechanisms explaining how HAIC may sensitize immunotherapy in the HCC immune microenvironment.

Sep 24, 2026

Uploaded by 4398046744996