Hepatic Artery Infusion Chemotherapy as a First‐Line Treatment in Unresectable Cholangiocarcinoma: A Systematic Review and Meta‐Analysis

INTRODUCTION Hepatic artery infusion chemotherapy (HAIC) has been used in efforts to improve outcomes in patients with locally advanced cholangiocarcinoma. Reported experiences are generally small institutional series. The efficacy of HAIC in locally advanced cholangiocarcinoma is not well defined.

METHODS We performed a comprehensive search using the electronic databases PubMed, Embase, Cochrane, ClinicalTrials. Gov, and WHO Clinical Trials from inception to August 2024.

RESULTS A total of 202 publications were screened, with 15 studies representing 588 patients meeting the inclusion criteria. Most patients demonstrated either a partial response or stable disease after therapy (CR: 2.5%, PR: 38.1%, SD: 43.4%, PD: 12.7%, NA: 3.3%). Meta-analysis found a pooled median overall survival of 18.3 months (95% CI: 14.1-22.4 months) and progression-free survival of 10.0 months (95% CI: 7.7-12.3 months).

CONCLUSION HAIC demonstrates an improvement over reported survival for systemic chemotherapy alone when used as either an adjunct or in place of systemic therapy for first-line treatment in patients with cholangiocarcinoma.