Abstract: Objective This study aimed to investigate the impacting efficacy factors of apatinib maintaining treatment after transcatheter hepatic artery chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC). Methods 138 patients with advanced HCC were recruited in our hospital between January 2018 and December 2019, and all patients received apatinib maintenance therapy after TACE for 2 to 3 courses of treatment. Serum alpha fetoprotein (AFP) level was detected by chemiluminescence immunoassay and plasma level of heat shock protein 90 α (Hsp90 α) was measured by ELISA. The impacting efficacy factors were analyzed by multivariate Logistic regression analysis. Results At the end of the treatment, 10 patients (7.2%) obtained complete response, 56 patients (40.6%) obtained partial response, 42 patients (30.4%) got stable disease, and 30 patients (21.7%) got progressive disease; the proportions of age older than 60 years, Child-Pugh class B, BCLC stage C, tumor diameter greater than 5 cm, serum AFP level greater than 400.0 U/L and HSP90 level greater than 460.0 ng/mL in patients with progressive disease were 57.4%, 55.2%, 53.2%, 55.3%, 62.5% and 65.7%, allsignificantly higher than 42.6%, 44.8%, 46.8%, 44.7%, 37.5% and 34.3% in the disease controlled group (P<0.05); the multivariate Logistic regression analysis showed that Child-Pugh classification, BCLC stage, serum AFP and HSP90 were the independent factors influencing the clinical efficacy of apatinib after TACE in patients with advanced HCC (P<0.05). Conclusion The apatinib maintenance therapy after TACE in the treatment of patients with advanced HCC has to some extent short-term efficacy, however, the clinicians should take some influencing efficacy factors into consideration, and select the eligible patients for treatment.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Apatinib, Heat shock protein 90α, Efficacy, Impacting factors