Outcomes of RALOX-HAIC-based Combination Therapy for Unresectable Hepatocellular Carcinoma with Radiomics-Powered
Peilin Zhu1, Zhanzhou Lin2, Zixi Liang3
1Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China; State Key Laboratory of Multi-organ Injury Prevention and Treatment; Key Laboratory of Infectious Diseases Research in South China (Southern Medical University), Ministry of Education; Guangdong Provincial Key Laboratory for Prevention and Control of Major Liver Diseases; Guangdong Provincial Clinical Research Center for Viral Hepatitis; Guangdong Institute of Hepatology; Guangdong Provincial Research Center for Liver Fibrosis Engineering and Technology, Guangdong 510515, PR China (P.Z., Y.C., C.H., K.S., W.L., Q.L., X.H., M.Z., J.C., G.Y.).
This study shows that a triple therapy of RALOX-HAIC, lenvatinib, and camrelizumab is effective for unresectable hepatocellular carcinoma (uHCC). A novel radiomics nomogram accurately predicts treatment outcomes, aiding personalized medicine for uHCC patients.
Area of Science:
- Hepatobiliary Malignancies
- Oncology
- Radiomics and Artificial Intelligence
Background:
- Unresectable hepatocellular carcinoma (uHCC) presents significant treatment challenges due to limited effective options.
- Current therapies for uHCC often yield unsatisfactory responses, necessitating novel approaches.
Purpose of the Study:
- To evaluate the efficacy and safety of a combined regimen of RALOX-HAIC, lenvatinib, and camrelizumab for uHCC.
- To develop and validate a radiomics-based nomogram for predicting treatment outcomes in uHCC patients.
Main Methods:
- A cohort of 98 uHCC patients received the triple therapy (RALOX-HAIC, lenvatinib, camrelizumab).
- Pretreatment CT images were used to extract radiomics features, integrated with clinical data (HBV status, Child-Pugh score).
- A radiomics nomogram was constructed and validated using AUC, calibration curves, and decision curve analysis (DCA).
Main Results:
- The triple therapy achieved an objective response rate (ORR) of 52.0% and a disease control rate (DCR) of 90.8%.
- Median progression-free survival (PFS) was 10.7 months; the radiomics nomogram demonstrated high predictive accuracy (AUC: 0.986 training, 0.873 validation).
- Common grade ≥3 toxicities included neutropenia and thrombocytopenia (68.4%), consistent with known profiles.
Conclusions:
- The integrated triple therapy demonstrates significant antitumor activity and a manageable safety profile in uHCC.
- The developed radiomics nomogram serves as a valuable tool for optimizing patient selection and personalizing treatment strategies for uHCC.
