Clinical efficacy of TACE combined with targeted or immune drugs for the treatment of unresectable intrahepatic cholangiocarcinoma

Purpose: To evaluate the clinical efficacy and safety of transarterial chemoembolization (TACE) combined with targeted or immune drugs for the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). Methods A total of 78 patients with unresectable ICC were retrospectively enrolled and analyzed. Objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and adverse events were assessed. Results Both the partial remission (PR) rate and ORR were significantly higher in the TACE combined group than in the TACE alone group (PR, 66.7% vs. 41.7%, P  = 0.027; ORR, 71.4% vs. 44.4%, P  = 0.016). The median PFS of the TACE combined group and the TACE alone group were 7.4 months (95% CI: 4.8–10.0) and 5.8 months (95% CI: 3.5–8.1), respectively, with a statistically significant difference ( P  = 0.028). The median OS of TACE combined group and the TACE alone group were 17.3 (95% CI: 13.8–20.7) months and 19.3 (95% CI: 7.9–30.7) months, respectively. Regarding independent risk factors, multifactorial analysis suggested that a bilirubin concentration > 20 µmol/L and multiple tumors were independent risk factors for PFS, while high concentrations of CA199 and alanine transaminase were independent risk factors for OS. In terms of side effects, the most common adverse events were abdominal pain, nausea and hypoalbuminemia. Conclusions TACE combined with targeted or immune drugs elicited a better short-term effect than TACE therapy alone, without an increase in the incidence of serious adverse events.