CapeOx -HAIC combined with tyrosine kinase inhibitors and immune checkpoint inhibitors for unresectable hepatocellular carcinoma: A multicenter propensity score-matched analysis.

[BACKGROUND] Hepatic artery infusion chemotherapy (HAIC) has become an important strategy for treating patients with unresectable hepatocellular carcinoma (uHCC). The mainstream FOLFOX regimen seriously affects the treatment experience of patients due to the need for continuous drug pumping for a long time. CapeOx regimen with oral capecitabine instead of continuous intravenous infusion of 5 - fluorouracil, is expected to be on the premise of not reduce the curative effect of treatment of convenience.

[METHODS] This study retrospectively analyzed 127 patients with uHCC who were treated with HAIC combined with tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs), including 31 cases in the CapeOx-HAIC group and 96 cases in the FOLFOX-HAIC group. The baseline differences were balanced through propensity score matching (PSM), and the differences in efficacy and safety between the two groups were compared.

[RESULTS] The CapeOx-HAIC group was slightly superior to the FOLFOX-HAIC group in terms of objective response rate (61.6% vs 46.1%) and disease control rate (88.5% vs 80.8%), but there was no significant statistical difference. Notably, the CapeOx-HAIC regimen was associated with significantly shorter durations of both chemotherapy and hospitalization, while maintaining a comparable safety profile to the FOLFOX-HAIC regimen.

[CONCLUSIONS] The CapeOx-HAIC regimen offers comparable efficacy and safety to FOLFOX-HAIC but with superior convenience due to shorter treatment and hospitalization. It represents a valuable "subtractive optimization" that is especially beneficial for frail patients, thereby simplifying clinical management and strengthening the basis for treatment plan selection.