Analysis of the clinical effect of metformin combined with camrelizumab and transcatheter arterial chemoembolization in the treatment of patients with advanced hepatocellular carcinoma complicated with type 2 diabetes mellitus
Li Yan
Wang Chunyu
Wei Pan
Chen Yaqiong
Cai Xiaoqing
Abstract：Objective To investigate the clinical effect of metformin combined with camrelizumab and transcatheter arterial chemoembolization(TACE)in the treatment of patients with advanced hepatocellular carcinoma complicated with type 2 diabetes mellitus(T2 DM).Methods The clinical data of 82 patients with advanced hepatocellular carcinoma and T2DM who were treated in the 940th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army from January 2018 to December 2022 were retrospectively analyzed.According to different treatment methods,the patients were divided into metformin group(42 cases)and control group(40 cases).The control group was treated with camrelizumab and TACE combined with non-metformin hypoglycemic drugs.The metformin group was treated with camrelizumab and TACE combined with metformin.The differences in immune function,biochemical indexes,tumor markers,efficacy and safety between the two groups were compared.Results After treatment,the levels of CD3+,CD4+T lymphocytes,CD4+/CD8+ratio,natural killer cell ratio,Interferon-γ,tumor necrosis factor-α,and interleukin-2 in the metformin group were all higher than those in the control group;the proportion of CD8+T lymphocytes,expression levels of interleukin-6 and programmed cell death receptor-1,aspartate aminotransferase,total bilirubin,alkaline phosphatase,aspartate aminotransferase to platelet ratio index,alpha fetoprotein levels,and positive rate of circulating tumor DNA were all lower than those in the control group(all P＜0.05).The objective response rate and disease control rate were significantly higher in the metformin group than those in the control group[61.9％(26/42)vs 30.0％(12/40),90.5％(38/42)vs 67.5％(27/40)](both P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups(all P＞0.05).Conclusion Metformin combined with camrelizumab and TACE can significantly improve the immune function,liver function and metabolic status of hepatocellular carcinoma patients with T2 DM,reduce tumor activity,and has good safety.
Keywords：Hepatocellular carcinomaType 2 diabetes mellitusProgrammed cell death receptor-1 inhibitorMetforminCombination therapy
Publication Date：2025-10-18
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1499-1503 )