Seoul St. Mary's Hospital study shows HAIC outperforms targeted therapy for advanced liver cancer

Study of 90 patients who failed immunotherapy

HAIC shows tumor response rate 6.9 times higher than targeted drugs

From left: Professor Sung Pil-soo of the Division of Gastroenterology at Seoul St. Mary's Hospital, Professor Nam Hee-chul of the Division of Gastroenterology at Uijeongbu St. Mary's Hospital, clinical instructor Tak Kwon-yong of the Division of Gastroenterology at Seoul St. Mary's Hospital, and Dr. Yoo Jae-sung of Kyungpook National University. [Provided by Seoul St. Mary's Hospital]

A research team at Seoul St. Mary's Hospital has published findings showing that hepatic arterial infusion chemotherapy, or HAIC, produced superior outcomes compared with oral targeted anticancer drugs as a second-line treatment for patients with advanced liver cancer.

The hospital said Thursday that a research team led by Professor Sung Pil-soo of the Division of Gastroenterology published the results of a study comparing HAIC and oral targeted therapy in patients with advanced hepatocellular carcinoma whose tumors did not respond to first-line immunotherapy combination treatment. The findings appeared in the international journal Radiology.

Treatment strategies for liver cancer must account for a range of factors, including tumor size and location, vascular invasion, liver function and overall patient condition. Evidence supporting effective second-line treatment options for patients whose cancer continues to progress after immunotherapy has remained limited.

The research team analyzed 90 patients with advanced hepatocellular carcinoma treated at four hospitals under the Catholic Medical Center network — Seoul St. Mary's, Uijeongbu St. Mary's, Bucheon St. Mary's and Eunpyeong St. Mary's — between March 2022 and August 2025. Of those, 51 received HAIC and 39 received oral targeted therapy.

The analysis found that the HAIC group showed markedly stronger tumor reduction. The objective response rate — the proportion of patients whose tumors shrank significantly — was 35.3 percent in the HAIC group, roughly 6.9 times higher than the 5.1 percent recorded in the targeted therapy group. The disease control rate, which includes patients whose tumors either shrank or stopped progressing, was 66.7 percent for the HAIC group compared with 25.6 percent for the targeted therapy group.

The median progression-free survival was also longer in the HAIC group at 7.1 months, versus 3.4 months in the targeted therapy group. The HAIC group's advantage held even after adjusting for variables that could affect outcomes, including age, liver function, overall condition, extent of intrahepatic tumor burden and vascular invasion.

Imaging scans showing the treatment response of a patient with advanced hepatocellular carcinoma following hepatic arterial infusion chemotherapy. [Provided by Seoul St. Mary's Hospital]

Notably, the HAIC group included a higher proportion of high-risk patients — those with extensive intrahepatic tumor burden or portal vein invasion — at 88.2 percent, compared with 64.1 percent in the targeted therapy group, yet still achieved superior tumor control.

HAIC delivers anticancer drugs directly to tumor sites by implanting a subcutaneous infusion port connected via catheter to the hepatic artery. The approach can be used in patients with cancer concentrated within the liver or those requiring rapid tumor control due to vascular invasion.

One case highlighted in the study involved a 68-year-old male patient with a massive infiltrative tumor filling the right lobe of the liver and portal vein tumor thrombosis. After eight cycles of HAIC, his tumor shrank and the portal vein thrombosis resolved, leaving him in a condition where liver transplantation could be considered.

However, the research team said the findings should not be interpreted as meaning HAIC is universally superior for all patients with advanced liver cancer. While HAIC may be effective for patients with disease concentrated in the liver, oral targeted therapy — which acts systemically — may be more appropriate when cancer has spread to other organs, making individualized treatment selection critical.

"This study is meaningful in that it offers a tailored treatment strategy for patients who need options after immunotherapy," Professor Sung said. "Liver function, tumor extent, vascular invasion and the presence of metastasis must all be weighed together to select the most appropriate treatment for each patient."

The study was published in the August issue of Radiology, an international journal in the field of diagnostic imaging published by the Radiological Society of North America, with an impact factor of 17.6.

woo@heraldcorp.com