Abstract: Objective The aim of this study was to investigate therapeutic efficacy of attilizumab and targeting and immune checkpoint inhibitor (ICPI) combination after transhepatic arterial chemoembolization (TACE) in the treatment of patients with advanced primary liver cancer (aPLC). Methods 126 patients with aPLC were recruited in our hospital between March 2017 and March 2021, and were randomly divided into observation and control group, with 63 cases in each group. TACE was routinely conducted in the two groups, patients in the control group were given apatinib, or sorafenib, and bevaccinium monoantibody therapy, and those in the observation group were treated with attilizumab at base of regimen in the control. All patients were followed-up for two years, and objective response rate (ORR) and disease control rate (DCR) 3 months after treatment were recorded. Peripheral blood T lymphocyte subsets were detected by flow cytometry and serum carcino-embryonic antigen (CEA), alpha-fetoprotein (AFP) and tissue polypeptide antigen (TPA) levels were assayed by ELISA. Results ORR and DCR in the observation group were 60.3% and 87.3%, significantly higher than 41.3% and 71.4% (P<0.05) in the control; after treatment, percentage of peripheral blood CD4⁺ cells and ratio of CD4⁺/CD8 ⁺ cells in the observation group were (38.4±4.3)% and (1.3±0.2), both significantly higher than [(33.6±3.8)% and (1.1±0.2), respectively, P＜0.05] in the control group; serum AFP and TPA levels were (92.6±25.8)ng/mL and (308.2±50.9)U/L, both much lower than [(177.6±41.3)ng/mL and (359.7±56.3, respectively, P＜0.05] in the control; 2-year survival rate in the observation group was 66.1%(41/62), much higher than 45.0%(27/60, x²=5.518, P=0.019) in the control group. Conclusion Combination of attillizumab, and target and ICPI therapy after TACE in the treatment of patients with aPLC is efficacious, which could prolong survivals, and might be related to the improvement of immune functions.

Key words: Hepatoma, Attilizul, Target medicine, Transhepatic artery chemoembolization, Therapy, Survivals