Abstract: Objective This clinical trial was conducted to investigate the efficacy of camrelizumab and apatinib combination in the treatment of patients with advanced hepatocellular carcinoma (HCC). Methods A total of 117 patients with advanced HCC were admitted to the first affiliated Hospital of Xinjiang Medical University between June 2019 and October 2021, and 65 patients were treated with camrelizumab and apatinib combination, and 52 patients were treated by apatinib alone. All patients were followed-up for one year. The therapeutic efficacy was evaluated according to mRECIST, the progression-free survival (PFS) and its influencing factors were analyzed by Kaplan-Meier method, and the prognostic factors of PFS were analyzed by multivariate COX regression. Results The objective remission rate (ORR) and the disease control rate (DCR) in patients with combination treatment were 44.7% and 66.2%, both significantly greater than 15.4% and 42.3% in the apatinib-treated patients (P<0.05); at the end of three-month treatment, the blood platelet count in patients with combination treatment was 81.0(51.5, 145.5)×10⁹/L, much lower than [107.0(69.5, 191.0)×10⁹/L P<0.05] in patients with apatinib treatment alone; the PFS in patients with combination treatment was 10.6 (95%CI:9.986-11.16) months, significantly longer than 7.9 (95%CI:6.84-8.944) months in the apatinib-treated group (Log-rank=12.807,P<0.05); the performance status (PS), Child-Pugh score, CNLC stage, liver cirrhosis, portal vein tumor thrombus and transarterial chemoembolization (TACE) were the prognostic factors impacting PFS, and the multivariate COX regression analysis showed that the Child-Pugh grade B (HR=2.379,P=0.021) and portal vein tumor thrombus (HR=3.481,P=0.003) were the independent risk factors for PFS, while the TACE (HR=0.528, P=0.034) was an independent protective factor for PFS in patients with advanced HCC. Conclusion The combination of camrelizumab and apatinib in treating patients with advanced HCC could effectively improve the clinical efficacy, with an obvious prolonged survival period. For patients with high tumor load, the auxiliary TACE might help raise better clinical benefits.

Key words: Hepatocellular carcinoma, Camrelizumab, Apatinib, Therapy, Advanced