Comparison of the efficacy and safety among apatinib plus drug-eluting bead transarterial chemoembolization (TACE), apatinib plus conventional TACE and apatinib alone in advanced intrahepatic cholangiocarcinoma

Abstract

This study aimed to compare the efficacy and safety of apatinib plus drug-eluting bead (DEB) transarterial chemoembolization (TACE), apatinib plus conventional TACE (cTACE) and apatinib alone in advanced intrahepatic cholangiocarcinoma (ICC) patients. We analyzed 35 advanced ICC patients retrospectively, including the apatinib plus DEB-TACE group (n=10), the apatinib plus cTACE group (n=12) and the apatinib group (n=13). Treatment response, survival data (including progression-free survival (PFS) and overall survival (OS)) and adverse events were assessed during the follow-up. Both the objective response rate (ORR) and the disease control rate (DCR) showed trends to be the highest in the apatinib plus DEB-TACE group (ORR: 84.6%/DCR: 100.0%), followed by the apatinib plus cTACE group (ORR: 75.0%/DCR: 91.7%) and then the apatinib group (ORR: 40.0%/DCR: 80.0%). PFS and OS were both the highest in the apatinib plus DEB-TACE group, followed by the apatinib plus cTACE group, and the shortest in the apatinib group, which was also confirmed by a multivariate Cox regression analysis. The incidences of adverse events were similar between the apatinib plus DEB-TACE group and the apatinib plus cTACE group but were higher in the apatinib plus DEB-TACE group and the apatinib plus cTACE than in the apatinib group; however, all of the adverse events were tolerable in the three groups. In conclusion, apatinib plus DEB-TACE is a promising therapeutic strategy for the treatment of advanced ICC.

Keywords: Intrahepatic cholangiocarcinoma; adverse events; apatinib; conventional transarterial chemoembolization; drug-eluting beads transarterial chemoembolization; efficacy.

Conflict of interest statement

None.

AJTR Copyright © 2020.

Figures

Figure 1

Longitudinal change of treatment response among three groups. A decreased trend of ORR (A) and DCR (B) for the apatinib group, apatinib plus cTACE group and apatinib plus DEB-TACE group. ORR, objective response rate; DCR, disease control rate; ICC, intrahepatic cholangiocarcinoma; cTACE, conventional transarterial chemoembolization; DEB-TACE, drug-eluting beads transarterial chemoembolization.

Figure 2

PFS among the three groups. PFS was the highest in the apatinib plus DEB-TACE group, followed by the apatinib plus cTACE group and it was the shortest in the apatinib group (A). Furthermore, PFS was longer in the apatinib plus DEB-TACE group compared with the apatinib plus cTACE group (B) and the apatinib group (C). In addition, PFS was increased in the apatinib plus cTACE group compared with the apatinib group (D). PFS, progression-free survival; ICC, intrahepatic cholangiocarcinoma; cTACE, conventional transarterial chemoembolization; DEB-TACE, drug-eluting beads transarterial chemoembolization.

Figure 3

OS among the three groups. OS was the longest in the apatinib plus DEB-TACE group, followed by the apatinib plus cTACE group, and the shortest in the apatinib group (A). Furthermore, OS was similar between the apatinib plus DEB-TACE group and the apatinib plus cTACE group (B) but was increased in the apatinib plus DEB-TACE group (C) and the apatinib plus cTACE group (D) compared with the apatinib group. OS, overall survival; ICC, intrahepatic cholangiocarcinoma; cTACE, conventional transarterial chemoembolization; DEB-TACE, drug-eluting beads transarterial chemoembolization.