Outcomes of RALOX-HAIC-based Combination Therapy for Unresectable Hepatocellular Carcinoma with Radiomics-Powered Prediction.
Authors
Affiliations (7)
Affiliations (7)
- Department 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.).
- Department of Hepatology, Huizhou Central People's Hospital, Huizhou, Guangdong, PR China (Z.L.).
- Department of Gastroenterology, Third Affiliated Hospital of Sun Yat‑Sen University, Guangzhou, Guangdong, PR China (Z.L.).
- Department of Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, PR China (Q.D.).
- Department of Oncology, Changde Hospital, Xiangya School of Medicine, Central South University (The First People's Hospital of Changde City), Changde, China (Y.D.).
- Department of Gastroenterology, the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong 510515, PR China (Y.S.).
- Department 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.). Electronic address: [email protected].
Abstract
Unresectable hepatocellular carcinoma (uHCC) remains a formidable clinical challenge owing to the scarcity of effective treatment options and unsatisfactory therapeutic responses. The current study explored a combined regimen of RALOX-HAIC, lenvatinib, and camrelizumab in patients with uHCC. In addition, a radiomics-based nomogram was created to predict treatment outcomes and support individualized decision-making. A total of 98 patients with uHCC received RALOX-HAIC, along with lenvatinib and camrelizumab. Before initiating therapy, radiomics features were derived from pretreatment computed tomography (CT) images and subsequently integrated with clinical variables, such as HBV status and Child-Pugh score. A radiomics nomogram was generated and assessed based on the area under the receiver operating characteristic curve (AUC), calibration analysis, and decision curve analysis (DCA). Triple therapy yielded an objective response rate (ORR) of 52.0%, disease control rate (DCR) of 90.8%, and median progression-free survival (PFS) of 10.7 months (95% CI: 7.3-20.5). The radiomics-guided nomogram showed high accuracy in the training (AUC: 0.986) and validation (AUC: 0.873) sets. The calibration curves showed close agreement between the projected and observed outcomes, and DCA confirmed the notable clinical merit. The main grade ≥3 toxicities included neutropenia and thrombocytopenia (68.4%), consistent with the profiles observed in comparable therapies. The integrated approach exhibited promising antitumor activity and an acceptable safety profile. Moreover, the radiomics nomogram is a valuable tool for refining patient selection and advancing personalized treatment strategies for individuals with uHCC.