Can't Have Surgery? HAIC Brings New Opportunities for Liver Cancer Patients
发布时间：2025-11-25
Recently, Dr. Jiang Jingwei from the Department of Medical Oncology and Dr. Yang Jihui from the Department of Interventional Radiology at Jiahui International Cancer Center, with strong support from Professor Li Jun, Director of the Department of General Surgery, and full supervision and guidance from Director Chen Peng of the Department of Imaging, successfully performed a hepatic artery infusion chemotherapy (HAIC) catheterization procedure for a patient with primary liver cancer. Subsequently, the nursing team led by Chief Nurse Li Hongmei from the Oncology Center followed up and successfully completed a continuous 2-day arterial infusion chemotherapy.
It is reported that this patient had no surgical resection opportunity at the initial diagnosis in late 2020, and the disease continued to progress despite multiple lines of treatment. In December of this year, after consultation in the outpatient clinic with Professor Zhu Xiuxuan and discussion by the multidisciplinary tumor board team at the Oncology Center, the decision was made to proceed with HAIC using the FOLFOX regimen. The patient has now completed HAIC treatment, with stable vital signs, and was successfully discharged after catheter removal.
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Surgery has long been the primary curative approach for liver cancer. However, liver cancer often develops insidiously, and in China, patients are frequently diagnosed with large tumors accompanied by satellite lesions, making radical resection impossible for most. For unresectable intermediate to advanced liver cancer, conventional transarterial chemoembolization (TACE) remains one of the main treatment modalities.
In recent years, FOLFOX-based HAIC treatment has gradually emerged. This treatment approach showed initial efficacy in a Phase II clinical study published in Chinese Journal of Cancer in 2017 [1]. Results from subsequent Phase III clinical trials were published online in the Journal of Clinical Oncology on October 14, 2021, demonstrating that FOLFOX-HAIC provides significant survival benefits for patients with initially unresectable large liver tumors (*Note: Barcelona Clinic Liver Cancer Stage A–B; China liver cancer staging Ib–IIb) [2].
The Phase III trial, which included a total of 315 patients in a randomized, multicenter, open-label study, showed that compared with conventional TACE, FOLFOX-HAIC significantly increased the probability of tumor shrinkage, extended overall survival, and caused fewer adverse reactions. Patients receiving FOLFOX-HAIC had a median survival of approximately 2 years, with about half showing significant tumor reduction, and around one-quarter undergoing curative surgery after tumor shrinkage, offering the potential for complete cure and long-term survival.
On December 14, 2021, the Journal of Clinical Oncology published the FOHAIC-1 study online, comparing the efficacy of FOLFOX-HAIC with sorafenib, a molecular targeted therapy, in advanced hepatocellular carcinoma (HCC). Sorafenib remains the standard first-line therapy for unresectable liver cancer. This study included 262 patients with primarily intrahepatic tumors, high tumor burden, and portal vein main trunk tumor thrombus. The Phase III trial showed that FOLFOX-HAIC achieved significantly better clinical outcomes and patient benefits than sorafenib in advanced HCC, suggesting that FOLFOX-HAIC may be a better clinical strategy for patients with large intrahepatic tumor burden [3].
Dr. Jiang Jingwei from the Department of Medical Oncology explained, “Hepatic artery infusion chemotherapy (HAIC) is an interventional treatment for liver cancer with advantages of being minimally invasive, highly repeatable, and requiring a short hospital stay. Compared with systemic chemotherapy, this technique significantly increases drug concentration in liver tumors while reducing distribution to other organs. It can quickly and effectively shrink tumors while minimizing systemic side effects. For unresectable primary liver cancer patients, HAIC can serve palliative or preoperative conversion purposes, potentially shrinking tumors, prolonging survival, and even creating opportunities for surgery. HAIC can also be used as adjuvant therapy after surgery to reduce the high risk of recurrence.”
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Currently, FOLFOX-HAIC has been included in the 2020 Chinese Society of Clinical Oncology (CSCO) Liver Cancer Guidelines [4].
In fact, the clinical application of HAIC is not limited to primary liver cancer. The liver is a common site of metastasis for various cancers, and the value of HAIC in treating liver metastases from colorectal, gastric, and other malignant tumors is worth further exploration and research.
Technically, HAIC is not complicated. Recent improvements mainly focus on chemotherapy regimens. The current FOLFOX regimen, like “old wine in a new bottle,” has revitalized HAIC. Researchers are also exploring combining HAIC with immunotherapy and targeted therapy to identify better treatment strategies. It is foreseeable that HAIC-centered therapies will play an increasingly important role in the treatment of both primary and metastatic liver cancer.
Jiahui International Cancer Center will continue to adopt globally synchronized advanced comprehensive treatment strategies. Through close collaboration among multiple departments and combining various methods—including HAIC, targeted therapy, immunotherapy, chemotherapy, radiotherapy, interventional therapy, and surgery—the center aims to offer more cancer patients new treatment opportunities, potential cures, and long-term survival.
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About HAIC Treatment
Indications: Multiple or large liver tumors
Anesthesia: Local anesthesia
Adverse reactions: Compared with conventional intravenous chemotherapy, systemic side effects such as gastrointestinal reactions and hair loss are reduced
Hospital stay: 4 days
Treatment frequency: Once every 3–4 weeks
*For HAIC consultation and appointment at Jiahui International Cancer Center, please call: 400 868 3000
References:
[1] He MK, Le Y, Li QJ, et al. Hepatic artery infusion chemotherapy using mFOLFOX versus transarterial chemoembolization for massive unresectable hepatocellular carcinoma: a prospective non-randomized study. Chin J Cancer. 2017;36(1):83. Published 2017 Oct 23. doi:10.1186/s40880-017-0251-2
[2] Li QJ, He MK, Chen HW, et al. Hepatic Arterial Infusion of Oxaliplatin, Fluorouracil, and Leucovorin Versus Transarterial Chemoembolization for Large Hepatocellular Carcinoma: A Randomized Phase III Trial [published online ahead of print, 2021 Oct 14]. J Clin Oncol. 2021;JCO2100608. doi:10.1200/JCO.21.00608
[3] Lyu N, Wang X, Li JB, et al. Arterial Chemotherapy of Oxaliplatin Plus Fluorouracil Versus Sorafenib in Advanced Hepatocellular Carcinoma: A Biomolecular Exploratory, Randomized, Phase III Trial (FOHAIC-1) [published online ahead of print, 2021 Dec 14]. J Clin Oncol. 2021;JCO2101963. doi:10.1200/JCO.21.01963
[4] Chinese Society of Clinical Oncology Guidelines Committee. CSCO Guidelines for Diagnosis and Treatment of Liver Cancer (2020 Edition) [M]. Beijing: People’s Medical Publishing House, 2020:59-60.
