Abstract: Objective The aim of this study was to investigate the efficacy of transcatheter arterial chemoembolization (TACE) and targeted immunotherapy combination in treatment of patients with advanced primary liver cancer (aPLC). Methods A total of 128 patients with aPLC were enrolled in our hospital between April 2021 and September 2024, and were randomly assigned to receive TACE in 64 cases, or receive TACE plus lenvatinib and sintilimab monoclonal antibody combination therapy in another 64 cases. Short-term efficacy was evaluated according to mRECIST. Serum α-L-fucosidase (AFU), alpha-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), hepatocyte growth factor (HGF), vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF), basic fibroblast growth factor (bFGF), cysteine aspartic protease-4 (Caspase-4) and survivin levels were detected by ELISA. Results Objective remission rate (ORR) and disease control rate (DCR) in combination treatment group were 42.2% and 79.7%, both significantly higher than 23.4% and 60.9% in TACE-treated group (P<0.05); after treatment, serum AFU,AFP and CA19-9 levels in combination-treated patients were (183.9±19.7)U/L, (349.7±21.8)ng/mL and (27.8±6.2)KU/L, all significantly lower than [(236.2±20.6)U/L, (461.3±24.6)ng/mL and (41.3±6.9)KU/L, respectively, P<0.05] in TACE alone-treated patients; serum HGF, VEGF, PDGFand bFGF levels were (71.5±7.9)ng/mL, (303.7±36.4)ng/L, (1507.4±302.4)ng/L and (101.3±14.5)ng/L, all much lower than [(94.9±8.7)ng/mL, (432.6±41.5)ng/L, (1963.6±314.7)ng/Land (141.5±15.3)ng/L, respectively, P<0.05] in the control; serum Caspase-4 level was (44.6±5.8)ng/mL, much higher than [(37.8±5.5)ng/mL, P<0.05), while serum survivin level was (21.1±3.9)ng/mL, much lower than [(26.1±3.7)ng/mL, P<0.05]in TACE alone-treated patients. Conclusion TACE plus targeted immunotherapy is an promising approach for management of patients with aPLC, which might relieve tumor burden and control the disease progression.

Key words: Hepatoma, Transcatheter arterial chemoembolization, Targeted therapy, Immunotherapy, Therapy