Retrospective study of TACE plus apatinib with or without camrelizumab for intermediate-advanced hepatocellular carcinoma in elderly patients

Transarterial chemoembolization (TACE) combined with targeted therapy and immunotherapy has emerged as a promising strategy for hepatocellular carcinoma (HCC). However, evidence specific to elderly patients (≥ 60 years) is limited. A retrospective study at Sanming First Hospital Affiliated to Fujian Medical University (Fujian, China) evaluated TACE combined with camrelizumab and apatinib in elderly patients with intermediate-advanced HCC. The study included 100 patients treated between June 2021 and June 2024. Patients were divided into a camrelizumab group (TACE + apatinib + camrelizumab; n=50) and a control group (TACE + apatinib; n=50) using propensity score matching. The camrelizumab group demonstrated significantly higher objective response rate (56.0% versus 32.0%; p= 0.016) and disease control rate (86.0% versus 68.0%; p=0.033) compared with the control group. Median progression-free survival (11.5 versus 5.9 months; p<0.001) and median overall survival (15.6 versus 11.6 months; p<0.001) were significantly prolonged with addition of camrelizumab. The overall incidence of adverse events was comparable between groups (34.0% versus 26.0%; p=0.382). The authors conclude that in this retrospective, single-center study, the addition of camrelizumab to TACE plus apatinib was associated with superior outcomes in elderly patients with intermediate-advanced HCC, with a manageable safety profile.