---
title: "Icaritin Combined with TACE for Hepatocellular Carcinoma: Analysis by Child‑Pugh Class"
id: "frontiers-in-immunology-12-efficacy-analysis-of-icaritin-combined-with-transarterial-chemoembolization-in"
canonical_url: "https://medichelpline.com/clinical-feed/frontiers-in-immunology-12-efficacy-analysis-of-icaritin-combined-with-transarterial-chemoembolization-in"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "Frontiers in Immunology"
source_url: "https://www.frontiersin.org/articles/10.3389/fimmu.2026.1876151"
published_at: "2026-07-30T00:00:00.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Icaritin Combined with TACE for Hepatocellular Carcinoma: Analysis by Child‑Pugh Class
## Provenance & Clinical Metadata
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- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** Frontiers in Immunology
- **Source URL:** [Original Journal Publication](https://www.frontiersin.org/articles/10.3389/fimmu.2026.1876151)
- **Published At:** 2026-07-30T00:00:00.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- The provided source page from Frontiers in Immunology contained site navigation and journal information but did not include the study text, data, methods, results, or conclusions for the article titled “Efficacy analysis of icaritin combined with transarterial chemoembolization in hepatocellular carcinoma stratified by different child‑pugh classes.” - Key study elements such as patient population, inclusion/exclusion criteria, sample size, Child‑Pugh class distribution, icaritin dosing regimen, transarterial chemoembolization (TACE) protocol, outcome measures (overall survival, progression‑free survival, tumor response rates), statistical methods, and safety/adverse event data were not reported on the captured page. - No numerical results, subgroup analyses by Child‑Pugh class, or statistical comparisons were available from the source content provided. - The source did not report ethical approval, trial registration, author list, institutions, funding, or conflicts of interest for the study. - Because the article body and supporting data were not present in the captured content, readers cannot assess efficacy, safety, or clinical applicability from this source alone; the original article or full text should be consulted for complete details. - Recommendations based on the available capture: retrieve the full Frontiers article PDF or the journal full‑text URL, or contact the journal/authors for the missing study information before applying any conclusions in clinical practice.
## Clinical Analysis & Structured Key Points
Frontiers | Efficacy analysis of icaritin combined with transarterial chemoembolization in hepatocellular carcinoma stratified by different child-pugh classes ORIGINAL RESEARCH article Front. Immunol. , 30 July 2026 Sec. Cancer Immunity and Immunotherapy Volume 17 - 2026 | https://doi.org/10.3389/fimmu.2026.1876151 Published in Frontiers in Immunology Cancer Immunity and Immunotherapy 7 impact factor 11.3 citescore Part of a Research Topic New Strategies and Clinical Translation Progress in Immunotherapy for Liver Cancer Submission open 43k views 22 articles Editor & Reviewers Edited by L S Luyan Shen Reviewed by P P Panuwat Promsorn Y Z Ying Zhang L K Lixin Ke Outline Figures and Tables Figure 1 View in article Figure 2 View in article Figure 3 View in article Figure 4 View in article Figure 5 View in article Table 1 Comparison of baseline characteristics for group between TACE with icaritin vs TACE alone after matching. View in article Table 2 Univariable and multivariable cox regression analysis of factors associated with overall survival in HCC patients. View in article Table 3 Univariable and multivariable cox regression analysis of factors associated with progression-free survival in HCC patients. View in article Table 4 Best overall tumor response before and after propensity score matching. View in article ORIGINAL RESEARCH article Front. Immunol. , 30 July 2026 Sec. Cancer Immunity and Immunotherapy Volume 17 - 2026 | https://doi.org/10.3389/fimmu.2026.1876151 Efficacy analysis of icaritin combined with transarterial chemoembolization in hepatocellular carcinoma stratified by different child-pugh classes J X Jingxuan Xu 1 † Y X Yao Xing 2 † F Z Fenhua Zhao 1 † B T Bufu Tang 3 X L Xinghai Li 4 J C Jiangping Cun 5 H L Huilin Lu 6 X X Xiangwen Xia 7,8,9 H F Hongjie Fan 7,8,9 * Y G Yuting Gu 10 * +2 more T X Tao Xu 7,8,9 * 1. Department of Radiology, Dongyang Hospital Affiliated to Wenzhou Medical University, Dongyang, Zhejiang, China 2. School of Clinical Medicine, North Sichuan Medical College, Nanchong, Sichuan, China 3. Department of Radiation Oncology, Zhongshan Hospital, Fudan University, Shanghai, China 4. Department of Minimally Invasive Intervention, Ganzhou People’s Hospital, Ganzhou, China 5. Department of Radiology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China 6. Department of Interventional Therapy, Xinxiang Central Hospital/the Fourth Clinical College of Xinxiang Medical University, Xinxiang, Henan, China 7. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China 8. Hubei Provincial Clinical Research Center for Precision Radiology & Interventional Medicine, Wuhan, China 9. Hubei Provincial Key Laboratory of Molecular Imaging, Wuhan, China 10. Department of Radiology, The First People’s Hospital of Yunnan Province, Kunming University of Science and Technology Affiliated Hospital, Kunming, China See more Article metrics View details Abstract Objective: To evaluate if transarterial chemoembolization (TACE) combined with Icaritin provides additional survival benefits compared to TACE alone in intermediate-to-advanced hepatocellular carcinoma (HCC) across different Child-Pugh classes. Background: TACE is a standard locoregional therapy for intermediate-to-advanced HCC, yet monotherapy yields limited long-term survival. Icaritin, an immunomodulator, demonstrates survival benefits in advanced HCC with a favorable safety profile lacking severe hepatotoxicity or bone marrow suppression. Methods: This multicenter retrospective cohort study included patients with Barcelona Clinic Liver Cancer (BCLC) stage B and C HCC. Propensity score matching (PSM) was utilized to balance baseline covariates between the TACE with Icaritin and TACE alone groups. The primary endpoint was overall survival (OS). Results: Following PSM, 250 patients were evaluated. In the Child-Pugh grade A group, TACE combined with Icaritin was associated with longer median OS than TACE alone (28.8 vs. 15.7 months; HR, 0.42; 95% CI, 0.29-0.62; P 3 months; and presence of portal vein tumor thrombosis (PVTT) that was limited without complete obstruction of the main portal vein. Exclusion criteria included: concurrent other malignancies; complete main portal vein obstruction unsuitable for embolization; severe coagulation disorders, hepatic encephalopathy, refractory ascites, or recent history of esophagogastric variceal bleeding; uncorrectable portosystemic shunting or active infection; and incomplete clinical or imaging follow-up data ( Figure 1 ). Figure 1 Flowchart of patient selection and propensity score matching. TACE procedure All patients underwent a comprehensive baseline assessment before the initial treatment, including routine blood tests, liver and kidney function tests, coagulation parameters, and contrast-enhanced abdominal CT or MRI to determine tumor burden, vascular anatomy, and portal vein patency. TACE procedures were performed by interventional radiologists with over 8 years of experience according to the “Clinical Application Management Standards and Quality Control Indicators for TACE in the Treatment of Liver Cancer (2024 Edition)”. The procedure was performed under local anesthesia using the Seldinger technique via femoral artery puncture. A 5Fr vascular sheath and a Yashiro catheter were used to locate the celiac trunk and superior mesenteric artery. A 2.7 Fr Progreat ® microcatheter was used for superselective catheterization into the target artery supplying the tumor (subsegmental or more distal branches). Subsequently, a chemotherapeutic emulsion (doxorubicin or cisplatin mixed with lipiodol) or drug-eluting beads was slowly injected until blood flow nearly stagnated. Finally, gelatin sponge particles were used for supplementary embolization to ensure complete blockage of tumor blood supply. After the procedure, the catheter was removed, compression hemostasis was applied at the puncture site, and symptomatic supportive care including hydration, analgesia, and antiemetics was provided. Systemic treatment regimen In the combination therapy group, patients started oral Icaritin after TACE, at a standard dose of 600 mg twice daily, taken after meals. During treatment, clinicians closely monitored changes in patients’ liver function. If drug-related liver function abnormalities occurred, temporary dose interruption or reduction was allowed, and treatment was resumed after symptom relief. During follow-up, if clinically indicated, the addition of other targeted agents (e.g., lenvatinib, donafenib, or sorafenib) was permitted according to clinical guidelines. Follow-up and efficacy assessment Patients were followed 4–6 weeks after initial TACE with contrast-enhanced CT or MRI, and tumor response was assessed using the modified Response Evaluation Criteria in Solid Tumors (mRECIST) ( 10 ). Repeat TACE was performed on demand for residual viable tumors if liver function permitted. AFP was monitored every 1–2 months, and imaging was repeated every 3 months. The primary endpoint of this study was OS, defined as the time from the date of initial TACE to death from any cause or last follow-up. The secondary endpoint was progression-free survival (PFS), defined as the time from treatment initiation to the first imaging-confirmed disease progression or death ( 11 ). Additionally, objective response rate (ORR, defined as the sum of complete response and partial response) and disease control rate (DCR, defined as the sum of complete response, partial response, and stable disease) were calculated. All AEs were recorded and graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) version 4.03. Statistical analysis Data were analyzed using SPSS 27.0 and R 4.5.1. Group comparisons utilized t-tests, Mann-Whitney U tests, chi-square, or Fisher’s exact tests as appropriate. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to balance baseline covariates and minimize confounding. Survival was estimated using the Kaplan-Meier method and log-rank test. Multivariate Cox proportional hazards regression identified independent prognostic factors for OS and PFS, including variables with P =2. Cox models were used to estimate treatment effects within each subgroup, and treatment-by-subgroup interaction terms were tested. To account for potential delayed immune responses, landmark analyses evaluated long-term survival for OS (at 4, 6, and 8 months) and PFS (at 2, 4, and 6 months). Additionally, a competing risk model (Fine-Gray test) assessed the cumulative incidence of disease progression, accounting for non-tumor-specific mortality. Statistical significance was defined as a two-sided P 0.05) ( Table 1 ; Supplementary Table S2 ; Supplementary Figure 1 ). Some patients experienced temporary treatment interruption, mainly due to treatment-related adverse events, additional anti-tumor interventions, additional TACE sessions, and combined targeted therapy. These interruptions lasted approximately 2 weeks to 2 months, after which all patients resumed the original treatment regimen. Dose reduction (Icaritin reduced to 200 mg once daily) was implemented in 8.0% of patients, who subsequently completed treatment. No patient permanently discontinued the TACE with Icaritin regimen due to serious adverse events. Table 1 Characteristics Unmatched Matched TACE alone n = 156 a TACE with Icaritin n = 148 a P b TACE alone n = 125 a TACE with Icaritin n = 125 a P b Sex 0.731 0.679 Male 141 (90%) 132 (89%) 113 (90%) 111 (89%) Female 15 (10%) 16 (11%) 12 (10%) 14 (11%) Age 0.826 0.698 0.999 0 104 (67%) 101 (68%) 84 (67%) 85 (68%) 1 50 (32%) 45 (30%) 39 (31%) 38 (30%) 2 2 (1%) 2 (1%) 2 (2%) 2 (2%) Targeted therapy 0.814 0.961 None 49 (31%) 46 (31%) 38 (30%) 36 (29%) Lenvatinib 59 (38%) 60 (41%) 51 (41%) 54 (43%) Donafenib 38 (24%) 36 (24%) 31 (25%) 29 (23%) Regorafenib 10 (6%) 6 (4%) 5 (4%) 6 (5%) Extrahepatic metastases d 0.787 0.625 No 142 (91%) 136 (92%) 115 (92%) 117 (94%) Yes 14 (9%) 12 (8%) 10 (8%) 8 (6%) Viral infection 0.156 0.811 No 2 (1%) 8 (5%) 2 (2%) 2 (2%) Hepatitis B 142 (91%) 133 (90%) 120 (96%) 117 (94%) Hepatitis C 9 (6%) 6 (4%) 3 (2%) 5 (4%) Other 3 (2%) 1 (1%) 0 (0%) 1 (1%) Portal vein tumor thrombus 0.062 0.998 None 73 (47%) 92 (62%) 68 (54%) 70 (56%) Type I 24 (15%) 20 (14%) 20 (16%) 20 (16%) Type II 49 (31%) 29 (20%) 31 (25%) 29 (23%) Type III 9 (6%) 6 (4%) 5 (4%) 5 (4%) Type IV 1 (1%) 1 (1%) 1 (1%) 1 (1%) AFP≥400 ng/mL 0.349 0.507 No 106 (68%) 93 (63%) 84 (67%) 79 (63%) Yes 50 (32%) 55 (37%) 41 (33%) 46 (37%) Number of lesions 0.115 0.471 ≤ 3 121 (78%) 103 (70%) 95 (76%) 90 (72%) >3 35 (22%) 45 (30%) 30 (24%) 35 (28%) Maximum diameter of lesion 0.181 0.296 <5 cm 61 (39%) 47 (32%) 51 (41%) 43 (34%) ≥ 5 cm 95 (61%) 101 (68%) 74 (59%) 82 (66%) Vascular invasion 0.002 0.722 No 3 (2%) 15 (10%) 3 (2%) 5 (4%) Yes 153 (98%) 133 (90%) 122 (98%) 120 (96%) Comparison of baseline characteristics for group between TACE with icaritin vs TACE alone after matching. TACE, transarterial chemoembolization; ECOG, Eastern Cooperative Oncology Group; AFP, alpha-Fetoprotein. a n (%). b Pearson’s Chi-squared test; Wilcoxon rank sum test; Fisher’s exact test. c ECOG score of 0 indicates that patients are fully active and able to carry on all pre-disease activities without restriction, and 1 indicates that patients are restricted in physically strenuous activity but is ambulatory and able to carry out work of a light nature, including self-care. d Extrahepatic metastases include metastasis to one or more sites such as the lung, bone, and peritoneum. OS and PFS Before matching, the median follow-up duration was 14.2 months (range 3.2-33.0), and the overall number of deaths was 253 (83.2%). Kaplan-Meier survival analysis showed that, across different Child-Pugh grades, TACE with Icaritin significantly improved patient survival outcomes compared to TACE alone: in Child-Pugh grade A patients, the median OS, 1-year OS rate, median PFS, and 1-year PFS rate were significantly better in the TACE with Icaritin group than in the TACE alone group (all P < 0.05); in Child-Pugh grade B patients, the median OS was significantly prolonged in the TACE with Icaritin group (P = 0.030) ( Supplementary Table 3 ; Figure 2 ). Figure 2 Kaplan-Meier curves of overall survival and progression-free survival in two groups under different child-pugh grades (A and B). (A) Overall survival periods of the two groups under Child-Pugh grade A. (B) Overall survival periods of the two groups under Child-Pugh grade B. (C) Progression-free survival in both groups under Child-Pugh grade A. (D) Progression-free survival in both groups under Child-Pugh grade B. After matching, the median follow-up duration was 14.3 months, and the mortality rates in the TACE with Icaritin and TACE alone groups were 41.6% and 83.2%, respectively (P < 0.001). Multivariate Cox
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