{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:57:34Z","timestamp":1790873854176,"version":"4.1.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"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>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Portal vein main trunk invasion is a serious and difficult complication of hepatocellular carcinoma (HCC), with extremely poor prognosis and limited treatment options. The traditional standard sorafenib has a limited efficacy. The combination of hepatic arterial infusion chemotherapy (HAIC) with camrelizumab and apatinib has shown satisfactory efficacy in previously advanced HCC. Therefore, this approach has potential advantageous survival benefits for HCC with invasion of the portal vein main trunk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was conducted on the clinical data of advanced HCC patients with type Vp4 portal vein invasion who received HAIC combined with apatinib and camrelizumab (HAICAC group) or HAIC alone (HAIC group) treatment in four medical centers from June 2016 to December 2023. Propensity score matching was employed to balance the baseline differences between the groups. The overall survival, progression-free survival, objective response rate and disease control rate were compared between the groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Following PSM, the HAICAC regimen demonstrated significantly superior clinical outcomes, with median OS (24.1 versus 7.2 months) and PFS (7.0 versus 4.3 months) significantly exceeding those of HAIC monotherapy (all P&amp;lt;0.001). The combination therapy also exhibited markedly improved tumor response rates, achieving superior objective response rates for both intrahepatic lesions (75.6% versus 31.4%, P&amp;lt;0.001) and PVTT (60.5% versus 17.4%, P&amp;lt;0.001). While the HAICAC group showed a higher incidence of immune-related adverse events compared to the HAIC group, all events were manageable and no grade 5 toxicities occurred.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For HCC with Vp4 type PVTT, the combination regimen of HAIC plus apatinib and camrelizumab demonstrates promising efficacy in reducing both intrahepatic tumor burden and thrombus progression, representing a potentially viable treatment approach with an acceptable safety profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fimmu.2026.1742116","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T06:34:43Z","timestamp":1771310083000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Hepatic arterial infusion chemotherapy combined with apatinib plus camrelizumab for advanced hepatocellular carcinoma with type Vp4 portal vein tumor thrombosis: a multicenter propensity score-matching analysis"],"prefix":"10.3389","volume":"17","author":[{"given":"Shaoteng","family":"Wu","sequence":"first","affiliation":[{"name":"Department of Tumor and Vascellum Intervention, DongGuan Tungwah Hospital","place":["DongGuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feifeng","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Interventional Surgery Room, The First Affiliated Hospital of Jinan University","place":["Guangzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fengtao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Vascular Interventional Surgery, Shenzhen Nanshan People\u2019s Hospital (Affiliated Nanshan Hospital of Shenzhen University)","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pingkang","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Interventional Therapy, Zhuhai People\u2019s Hospital (Zhuhai Clinical Medical College of Jinan University)","place":["Zhuhai, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiang","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Interventional Therapy, Zhuhai People\u2019s Hospital (Zhuhai Clinical Medical College of Jinan University)","place":["Zhuhai, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiming","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Interventional, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiming","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology, the First Affiliated Hospital of Guangdong Pharmaceutical University","place":["Guangzhou, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Qian","sequence":"additional","affiliation":[{"name":"School of Science and Engineering, The Chinese University of Hong Kong Shenzhen","place":["Shenzhen, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankang","family":"Shu","sequence":"additional","affiliation":[{"name":"Department of Tumor and Vascellum Intervention, DongGuan Tungwah Hospital","place":["DongGuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Tumor and Vascellum Intervention, DongGuan Tungwah Hospital","place":["DongGuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dejun","family":"Xiong","sequence":"additional","affiliation":[{"name":"Department of Tumor and Vascellum Intervention, DongGuan Tungwah Hospital","place":["DongGuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheng","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Tumor and Vascellum Intervention, DongGuan Tungwah Hospital","place":["DongGuan, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J 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