{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T01:05:06Z","timestamp":1781917506151,"version":"3.54.5"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T00:00:00Z","timestamp":1752624000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Intrahepatic cholangiocarcinoma (iCC) is an aggressive hepatobiliary malignancy with limited therapeutic options and poor survival outcomes. Hepatic arterial infusion chemotherapy (HAIC) has emerged as a promising treatment alternative to systemic chemotherapy, but its clinical benefits require comprehensive evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review and meta-analysis were conducted, including 10 studies with 1,493 patients. Data on overall survival (OS), progression-free survival (PFS), and key prognostic factors were extracted. Pooled hazard ratios (HR) were calculated using a random-effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>HAIC significantly improved OS (HR = 0.51, p &amp;lt; 0.001) and PFS (HR = 0.58, p &amp;lt; 0.001) compared to systemic chemotherapy. Subgroup analyses revealed consistent benefits across various patient characteristics, including age, tumor stage, and baseline liver function. Patients with lower tumor burden (HR = 0.45) and ECOG performance status \u22641 (HR = 0.50) derived the greatest benefit. Additionally, patients with CA 19\u20139 levels &amp;lt;1,000 U\/mL showed significantly improved OS (HR = 0.48).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>HAIC prolongs survival and improves disease control in advanced iCC patients compared to systemic chemotherapy. These findings support the adoption of HAIC as a valuable treatment strategy for selected patients, particularly those with lower tumor burden and favorable performance status.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/<\/jats:uri>, identifier CRD42024615752.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2025.1640970","type":"journal-article","created":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T15:48:58Z","timestamp":1752680938000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Hepatic arterial infusion chemotherapy versus systemic chemotherapy for advanced intrahepatic cholangiocarcinoma: a meta-analysis of survival 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