Abstract: Objective The aim of this study was to investigate clinical efficacy of bevacizumab and sintilimab combination after transcatheter arterial chemoembolization (TACE) in the treatment of patients with unresectable hepatocellular carcinoma (HCC). Methods 96 patients with unresectable HCC were enrolled in our hospital between June 2021 and January 2024, and were randomized into two groups, with 48 cases in each group. Patients in control group were treated with intravenously sintilimab after TACE, and those in the observation were dealt with intranenous bevacizumab and sintilimab combination after TACE for 4 treatment course. Serum alpha-fetoprotein (AFP), basic fibroblast growth factor (bFGF), vascular endothelial growth factor (VEGF) and protein induced by vitamin K absence or antagonist-II (PIVKA-Ⅱ) levels were detected by ELISA, and peripheral blood lymphocyte subsets were detected by flow cytometry. The 1-year overall survival rate and progression-free survival rate were recorded. Results By end of treatment course, the objective remission rate assessed by modified response evaluation criteria in solid tumors in the observation group was 83.3%, significantly higher than 62.5% in the control (P<0.05); serum AFP, bFGF, VEGF and PIVKA-Ⅱ levels in the observation group were (77.9±31.7)ng/mL, (4.2±0.8)pg/mL, (82.7±18.3)pg/mL and (652.9±102.4)mAU/L, all much lower than [(169.4±57.4)ng/mL, (5.3±1.0)pg/mL, (124.5±20.9)pg/mL and (764.0±113.9)mAU/L, respectively, all P<0.05] in the control; percentage of peripheral blood CD4⁺ cells and CD4⁺/CD8⁺ cell ratio were (34.5±2.8)% and (1.4±0.2), both much higher than [(30.1±3.1)% and (1.2±0.2), P<0.05] in the control; incidence of adverse effects in the two groups were not significantly different(P＞0.05); by end of one-year follow-up, the total survival rate in the observation was 83.3%, not significantly different compared to 68.8% in the control (P＞0.05), while the progression-free survival rate was 79.2%, much higher than 58.3%(P<0.05) in the control group. Conclusion Combination of bevacizumab and sintilimab after TACE in the treatment of patients with advanced HCC is short-termly efficacious, which might be related to modulation of body immune functions and inhibition of angiogenesis.

Key words: Hepatocellular carcinoma, Transcatheter arterial chemoembolization, Bevacizumab, Sintilimab, Therapy