Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma

Abstract For locally advanced intrahepatic cholangiocarcinoma (ICC), the combination of cisplatin plus gemcitabine (CisGem) is the standard first-line treatment. However, the outcome remains unsatisfied with the median overall survival (OS) of 11.7 months. We aimed to compare the effect of CisGem re...

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Main Authors: Lin Liu, Huanhuan Wang, Liang Sun, Yufang Liu, Yujing Zhang, Xutian Wang, Xin Zheng
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-09586-8
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author Lin Liu
Huanhuan Wang
Liang Sun
Yufang Liu
Yujing Zhang
Xutian Wang
Xin Zheng
author_facet Lin Liu
Huanhuan Wang
Liang Sun
Yufang Liu
Yujing Zhang
Xutian Wang
Xin Zheng
author_sort Lin Liu
collection DOAJ
description Abstract For locally advanced intrahepatic cholangiocarcinoma (ICC), the combination of cisplatin plus gemcitabine (CisGem) is the standard first-line treatment. However, the outcome remains unsatisfied with the median overall survival (OS) of 11.7 months. We aimed to compare the effect of CisGem regimen and hepatic arterial infusion chemotherapy (HAIC) with Folfox 4 for locally advanced ICC. 97 Locally advanced ICC patients treated by CisGem regimen or HAIC with Folfox 4 in our institution from 2017 to 2019 were studied as training group. 43 locally advanced ICCs receiving CisGem chemotherapy or HAIC with Folfox 4 were investigated as validation group. The median OS was 14.5 months among 37 ICC patients from the HAIC group and 10.3 months among 60 ICC cases in the CisGem group. The median PFS in the HAIC group was 8.2 months in contrast to 5.3 months in the CisGem group. Additionally, objective response rate (ORR) in the HAIC group was markedly better than one in the CisGem group (29.7% v 5.0%). Patients from the HAIC group suffered from less AE (particularly 3–4 grade AE) than those in the CisGem group. The prediction nomogram models for OS and PFS were built respectively after Cox multivariate analysis, which were confirmed to be clinically useful by external validation cohort. These data here suggested HAIC with Folfox 4 was a potential first-line treatment option for local advanced ICC.
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spelling doaj-art-7bc25d1287964689bceaf010abb87d4d2025-08-20T03:37:30ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-09586-8Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinomaLin Liu0Huanhuan Wang1Liang Sun2Yufang Liu3Yujing Zhang4Xutian Wang5Xin Zheng6Department of Anesthesiology, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Hepatobiliary Surgery, Nanzheng People HospitalDepartment of Hepatobiliary Surgery, Shangluo Central HospitalDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong UniversityAbstract For locally advanced intrahepatic cholangiocarcinoma (ICC), the combination of cisplatin plus gemcitabine (CisGem) is the standard first-line treatment. However, the outcome remains unsatisfied with the median overall survival (OS) of 11.7 months. We aimed to compare the effect of CisGem regimen and hepatic arterial infusion chemotherapy (HAIC) with Folfox 4 for locally advanced ICC. 97 Locally advanced ICC patients treated by CisGem regimen or HAIC with Folfox 4 in our institution from 2017 to 2019 were studied as training group. 43 locally advanced ICCs receiving CisGem chemotherapy or HAIC with Folfox 4 were investigated as validation group. The median OS was 14.5 months among 37 ICC patients from the HAIC group and 10.3 months among 60 ICC cases in the CisGem group. The median PFS in the HAIC group was 8.2 months in contrast to 5.3 months in the CisGem group. Additionally, objective response rate (ORR) in the HAIC group was markedly better than one in the CisGem group (29.7% v 5.0%). Patients from the HAIC group suffered from less AE (particularly 3–4 grade AE) than those in the CisGem group. The prediction nomogram models for OS and PFS were built respectively after Cox multivariate analysis, which were confirmed to be clinically useful by external validation cohort. These data here suggested HAIC with Folfox 4 was a potential first-line treatment option for local advanced ICC.https://doi.org/10.1038/s41598-025-09586-8Hepatic arterial infusion chemotherapyIntrahepatic cholangiocarcinomaFolfox 4GemcitabineCisplatin
spellingShingle Lin Liu
Huanhuan Wang
Liang Sun
Yufang Liu
Yujing Zhang
Xutian Wang
Xin Zheng
Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
Scientific Reports
Hepatic arterial infusion chemotherapy
Intrahepatic cholangiocarcinoma
Folfox 4
Gemcitabine
Cisplatin
title Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
title_full Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
title_fullStr Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
title_full_unstemmed Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
title_short Hepatic arterial infusion chemotherapy with Folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
title_sort hepatic arterial infusion chemotherapy with folfox 4 regimen versus cisplatin and gemcitabine for locally advanced intrahepatic cholangiocarcinoma
topic Hepatic arterial infusion chemotherapy
Intrahepatic cholangiocarcinoma
Folfox 4
Gemcitabine
Cisplatin
url https://doi.org/10.1038/s41598-025-09586-8
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