Hepatic arterial infusion chemotherapy (HAIC)--hepatocellular carcinoma

Hepatic arterial infusion chemotherapy (HAIC) has been often selected as a therapeutic option for advanced hepatocellular carcinoma (HCC) with intrahepatic metastases or portal vein thrombosis, which is not eligible for hepatic resection, tumor ablation, or embolization. Among various regimens, HAIC, consisting of 5-fluorouracil (5-FU) in combination with either low-doses of cisplatin (CDDP) or interferon-alpha has been reported to improve the response rates for advanced HCC. As both regimens require the use of an implanted port-catheter system, maintaining the patency of hepatic arteries is an important factor for the intrahepatic drug distribution and the efficacy of HAIC. Recently, a new product, CDDP powder has been also developed for intraarterial use, which adds a new option to HAIC. However, the long-term outcome or the survival benefit remains unclear with HAIC, and it may be significantly affected by liver function and cirrhosis. None of the regimens have been proved to be the standard for HAIC, and prospective multi-center clinical studies with standardized protocol are needed in the future.