经证据表明，对于无法手术切除的肝细胞癌（HCC），经导管肝动脉化疗栓塞（TACE）加酪氨酸激酶抑制剂和免疫检查点抑制剂的证据有限。本研究旨在评估TACE加阿帕替尼（TACE + A）和TACE联合阿帕替尼和卡瑞利珠单抗的作用（TACE + AC）在无法手术切除的HCC患者中的作用。本研究回顾性地审查了中国20个中心在2019年1月1日至2021年6月31日接受TACE + A或TACE + AC治疗的无法手术切除的HCC患者。进行1：1的倾向性分值匹配（PSM）以减少偏差。收集治疗相关不良事件（TRAEs），总生存期（OS），无进展生存期（PFS），客观缓解率（ORR）和疾病控制率（DCR）。共纳入960名符合条件的HCC患者进行最终分析。经过PSM，每组均有449名患者，两组基线特征平衡。在数据截止时，中位随访时间为16.3（范围为11.9-21.4）个月。经过PSM后，TACE + AC组的中位OS（24.5 vs 18.0个月，p <0.001）和PFS（10.8 vs 7.7个月，p <0.001）比TACE + A组更长； TACE + AC组的ORR（49.9％vs 42.5％，p = 0.002）和DCR（88.4％vs 84.0％，p = 0.003）也高于TACE + A组。在两组中，发热，疼痛，高血压和手-足综合征是更常见的TRAEs。TACE加阿帕替尼和TACE联合阿帕替尼和卡瑞利珠单抗在无法手术切除的HCC患者中可行，并具有可管理的安全性。 此外，TACE联合阿帕替尼和卡瑞利珠单抗还显示了额外的益处。 © 2023年。作者（们）。

The evidence of transcatheter arterial chemoembolization (TACE) plus tyrosine kinase inhibitor and immune checkpoint inhibitor in unresectable hepatocellular carcinoma (HCC) was limited. This study aimed to evaluate the role of TACE plus apatinib (TACE + A) and TACE combined with apatinib plus camrelizumab (TACE + AC) in patients with unresectable HCC.This study retrospectively reviewed patients with unresectable HCC who received TACE + A or TACE + AC in 20 centers of China from January 1, 2019 to June 31, 2021. Propensity score matching (PSM) at 1:1 was performed to reduce bias. Treatment-related adverse events (TRAEs), overall survival (OS), progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR) were collected.A total of 960 eligible patients with HCC were included in the final analysis. After PSM, there were 449 patients in each group, and the baseline characteristics were balanced between two groups. At data cutoff, the median follow-up time was 16.3 (range: 11.9-21.4) months. After PSM, the TACE + AC group showed longer median OS (24.5 vs 18.0 months, p < 0.001) and PFS (10.8 vs 7.7 months, p < 0.001) than the TACE + A group; the ORR (49.9% vs 42.5%, p = 0.002) and DCR (88.4% vs 84.0%, p = 0.003) of the TACE + AC group were also higher than those in the TACE + A group. Fever, pain, hypertension and hand-foot syndrome were the more common TRAEs in two groups.Both TACE plus apatinib and TACE combined with apatinib plus camrelizumab were feasible in patients with unresectable HCC, with manageable safety profiles. Moreover, TACE combined with apatinib plus camrelizumab showed additional benefit.© 2023. The Author(s).