Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma

Hepatic arterial infusion chemotherapy (HAIC) has re-emerged as a pivotal regional treatment for advanced hepatocellular carcinoma (HCC). By infusing cytotoxic agents directly into the hepatic artery, HAIC achieves markedly elevated intratumoural drug concentrations while limiting systemic exposure. The adoption of FOLFOX regimens (oxaliplatin, fluorouracil and leucovorin) and improvements in catheter technology have enhanced delivery precision and tolerability. Globally, HAIC is deployed both as a first-line approach for large or portal vein‐invading tumours and as a conversion therapy to downstage lesions for surgical resection or transplantation. Integration with targeted therapies (such as tyrosine kinase inhibitors) and immune checkpoint inhibitors has further amplified antitumour efficacy, yielding higher response rates and extending progression-free intervals. Current research focuses on refining patient selection through biomarker stratification, optimising infusion schedules and exploring synergistic combinations with systemic agents. As a bespoke locoregional technique, HAIC is increasingly incorporated into multidisciplinary management pathways, underscoring its growing clinical relevance in HCC care.

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Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma publication trend

The graph below shows the total number of articles in hepatic arterial infusion chemotherapy in hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).

Technical terms

Hepatic arterial infusion chemotherapy (HAIC): Regional delivery of chemotherapeutic agents via the hepatic artery to concentrate drug exposure in liver tumours and reduce systemic toxicity.

Hepatocellular carcinoma (HCC): Primary malignant tumour arising from hepatocytes, often associated with chronic liver disease and cirrhosis.

FOLFOX: Chemotherapy regimen combining oxaliplatin, fluorouracil and leucovorin, widely used in regional infusion protocols.

Objective response rate (ORR): Proportion of patients achieving a predefined reduction in measurable tumour burden.

Progression-free survival (PFS): Length of time during and after treatment that a patient lives without radiological or clinical disease progression.

RECIST and mRECIST: Standardised criteria for tumour response assessment; mRECIST accounts for viable tumour tissue in HCC.

References

1. Camrelizumab (a PD-1 inhibitor) plus apatinib (an VEGFR-2 inhibitor) and hepatic artery infusion chemotherapy for hepatocellular carcinoma in Barcelona Clinic Liver Cancer stage C (TRIPLET): a phase II study. Signal Transduction and Targeted Therapy (2023).
2. Efficacy and safety of atezolizumab plus bevacizumab combined with hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma. Frontiers in Immunology (2022).
3. Hepatic arterial infusion chemotherapy versus transarterial chemoembolization for unresectable hepatocellular carcinoma: A systematic review with meta-analysis. Frontiers in Bioengineering and Biotechnology (2022).