Infusion of PD1/PDL1/CTLA4 Inhibitors Via Hepatic Arterial for Immunotherapy of Hepatocellular Carcinoma

Prior treatment

• Patients participated in clinical trials of equipment or drugs (signed informed consent) within 4 weeks;
• Any agents which could affect the absorption or pharmacokinetics of the study drugs

Other illness

• Patients accompany by ascites, hepatic encephalopathy and esophageal and gastric varices bleeding;
• Any serious accompanying disease, which is expected to have an unknown, impact on the prognosis, include heart disease, inadequately controlled diabetes and psychiatric disorders;
• Patients accompanied with other tumors or past medical history of malignancy;
• Patients have the past history of liver cancer treatment, such as transplantation, resection, radiotherapy, chemotherapy and so on;
• Allergic to adriamycin chemotherapy drugs，contrast agent and lipiodol;

Lab values

• Patients have poor compliance.
  • Any contraindications for hepatic arterial infusion procedure:
  • A.Impaired clotting test (platelet count \< 60000/mm3, prothrombin activity \< 50%).
  • B.Renal failure / insufficiency requiring hemo-or peritoneal dialysis. C.Known severe atheromatosis. D.Known uncontrolled blood hypertension (\> 160/100 mm/Hg).

Other

• Pregnant or lactating patients, all patients participating in this trial must adopt appropriate birth control measures during treatment;
• Subjects unable to suffer the discomfort of the HAI procedure

• Cytohistological confirmation is required for diagnosis of HCC.、
• Signed informed consent before recruiting
• Age between 18 to 80 years with estimated survival over 3 months.
• Child-Pugh class A or B/Child score \> 7; ECOG score \< 2
• Tolerable coagulation function or reversible coagulation disorders
• Laboratory examination test within 7 days prior to procedure: WBC≥3.0×10E9/L; Hb≥90g/L； PLT ≥50×10E9/L；INR \< 2.3 or PT \< 6 seconds above control；Cr ≤ 145.5 umul/L；Albumin \> 28 g/L；Total bilirubin \< 51 μmol/L
• At least one tumor lesion meeting measurable disease criteria as determined by RECIST v1.1.
• Patients with advanced (unresectable and/or metastatic, stage C based on Barcelona-Clinic Liver Cancer \[BCLC\] staging classification) hepatocellular carcinoma which would not be suitable for treatment with loco-regional therapies or have progressed following locoregional therapy such as surgical resection, percutaneous hepatic arterial embolization, radiofrequency ablation, and percutaneous interventional therapy.
• Birth control.
• Willing and able to comply with scheduled visits, treatment plan and laboratory tests.