Transarterial infusion chemotherapy with FOLFOX for advanced hepatocellular carcinoma:a multi-center propensity score matched analysis of real-world practice

Background:To compare the treatment effectiveness and safety among transarterial infusion chemotherapy(TAI)with FOLFOX regimen,transarterial chemoembolization(TACE),and sorafenib in patients with BCLC stage C hepatocellular carcinoma(HCC).Methods:The data of consecutive patients with BCLC stage C HCC treated with TAI,TACE,or sorafenib from January 2015 to December 2018 at three centers were retrospectively analyzed.Propensity-score matched(PSM)analysis was pairwise performed to reduce selection bias.Treatment effectiveness and safety were evaluated and compared using the Kaplan-Meier method,log-rank test,Cox regression models,andχ2 test.Results:The median overall survival(OS)in the matched TAI cohort was significantly longer than the sorafenib cohort(19.6 vs.7.5 months,P=0.009),and the TACE cohort(estimated 27.8 vs.6.6 months,P<0.001).The difference in median progression-free survival(PFS)between the matched TAI and sorafenib cohorts was not significant(5.8 vs.2.3 months,P=0.219).The median PFS in the matched TAI cohort was significantly longer than the TACE cohort(6.5 vs.2.8 months,P<0.001).The objective response rate(ORR)in the matched TAI cohort was significantly higher than the sorafenib cohort(36.4%vs.0.0%,P<0.001)and the TACE cohort(48.7%vs.4.7%,P<0.001).The incidences of adverse events(AEs)were similar among these three cohorts.Conclusions:TAI with FOLFOX regimen was an effective and safe therapy that improved survival of patients with BCLC stage C HCC.