Consistent efficacy of hepatic artery infusion chemotherapy irrespective of PD‑L1 positivity in unresectable hepatocellular carcinoma

Atezolizumab/bevacizumab is the first line of treatment for unresectable hepatocellular carcinoma (HCC), combining immune checkpoint inhibitor and anti‑VEGF monoclonal antibodies. Hepatic arterial infusion chemotherapy (HAIC) is administered when the above‑described combina‑ tion fails to confer sufficient clinical benefit. The present study aimed to explore the association between tumor programmed cell death‑ligand 1 (PD‑L1) positivity and HAIC response. A total of 40 patients with HCC who had undergone HAIC with available biopsy samples obtained between January 2020 and May 2023 were retrospectively enrolled. Tumor response, progression‑free survival (PFS), disease control rate (DCR) and overall survival (OS) were evaluated. PD‑L1 expression in tumor samples was assessed using a combined positivity score. The response rates of HAIC‑treated patients with advanced HCC after failure of atezolizumab/bevacizumab combination therapy were recorded. OS (P=0.9717) and PFS (P=0.4194) did not differ between patients with and without PD‑L1 positivity. The objective response rate (P=0.7830) and DCR (P=0.7020) also did not differ based on PD‑L1 status. In conclusion, the current findings highlight the consistent efficacy of HAIC, regardless of PD‑L1 positivity.