Efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE) plus apatinib versus DEB-TACE alone in treating huge hepatocellular carcinoma patients

Abstract

Background Apatinib, a tyrosine kinase inhibitor, inhibits angiogenesis under the tumor hypoxic environment induced by drug-eluting bead transarterial chemoembolization (DEB-TACE), which is hypothesized to have synergic effect with DEB-TACE in treating hepatocellular carcinoma (HCC) patients. This study aimed to evaluate the efficacy and safety of DEB-TACE plus apatinib in treating huge HCC patients. Methods Totally, 73 huge HCC patients (tumor size > 10 cm) were screened and divided into DEB-TACE plus apatinib group (N = 34) or DEB-TACE group (N = 39) based on the treatment they received. Their clinical response and adverse events were retrieved. The progression-free survival (PFS) and overall survival (OS) were calculated. Results DEB-TACE plus apatinib achieved a trend of higher objective response rate (64.7% vs. 43.6%, P = 0.071), but similar disease control rate (88.2% vs. 79.5%, P = 0.314) than DEB-TACE alone. Moreover, DEB-TACE plus apatinib reached an improved PFS (median (95%CI): 19.0 months (15.5–22.5) vs. 10.9 months (8.0–13.8), P = 0.025) and OS (median (95%CI): 25.1 months (20.3–29.9) vs. 13.7 months (9.8–17.6), P = 0.042) than DEB-TACE alone. After adjustment by multivariate Cox’s regression analyses, DEB-TACE plus apatinib (vs. DEB-TACE alone) was independently correlated with better PFS (HR: 0.420, P = 0.004) and OS (HR: 0.477, P = 0.022). Regarding safety, adverse events were mostly mild and manageable; also, they were of no difference between DEB-TACE plus apatinib and DEB-TACE alone (all P > 0.05). Conclusion DEB-TACE plus apatinib achieves prolonged PFS and OS, while similar adverse events occurrence compared to DEB-TACE alone in huge HCC treatment.

A Simple Prognostic Scoring System for Hepatocellular Carcinoma Treated with DEB-TACE

“…Overall, these results were comparable to those reported in other literature on the treatment of unresectable HCC with DEB-TACE. 11 , 12 However, they were significantly better than previously reported survival of c-TACE in the treatment of advanced HCC. 13 , 14 The primary objective of this study was to identify factors that affect the prognosis of DEB-TACE in the treatment of unresectable HCC and to establish a simple, practical, and reliable prognostic scoring system to predict the efficacy and survival benefit of DEB-TACE in HCC patients.…”

What Is the Most Suitable Agent Combined With Apatinib for Transarterial Chemoembolization Treatment in Advanced Hepatocellular Carcinoma Patients? A Systematic Review and Network Meta-analysis

“…TACE+apatinib treatment could inhibit metastasis after TACE procedure with contracted tumor feeding artery for advanced HCCs without metastasis ( 70 ). In addition, Li’s research revealed that DEB-TACE plus apatinib achieves prolonged PFS and OS, while similar adverse events occurrence were observed when compared to DEB-TACE alone in huge HCC treatment ( 71 ). Moreover, Ju’s research declared that DEB-TACE followed by apatinib is effective and safe in treating BCLC stage C HCC patients, which indicates its role as an acceptable option in HCC management ( 72 ).…”

Comparative efficacy and safety of molecular targeted agents combined with transarterial chemoembolization in the treatment of unresectable hepatocellular carcinoma: a network meta-analysis

“…There were 10,774 HCC patients in our 45 included studies. Among them, 19 studies ( 11 – 14 , 21 – 35 ) were about the comparison of Sora+TACE and TACE monotherapy, 3 studies ( 36 – 38 ) were about the comparison of Lenv+TACE and TACE monotherapy, 11 studies ( 15 , 39 – 48 ) were about the comparison of Apat+TACE and TACE monotherapy, 1 studies ( 49 ) was about the comparison of Anlo+TACE and TACE monotherapy, 1 study ( 16 ) was about the comparison of Briv+TACE and TACE monotherapy, and 2 studies ( 17 , 50 ) were about the comparison of Suni+TACE and TACE monotherapy, and 3 studies ( 18 – 20 ) were about the comparison of Oran+TACE and TACE monotherapy. Moreover, there were 2 studies ( 51 , 52 ) on the comparison of Lenv+TACE and Sora+TACE, 2 studies ( 53 , 54 ) on the comparison of Sora+TACE and Apat+TACE, and 1 study ( 55 ) on the comparison of Suni+TACE and Sora+TACE.…”