FOLFOX-HAIC for Unresectable Large Hepatocellular Carcinoma: The Effectiveness Has Yet to be Determined

Mei, Junhao; Yu, Haiyang; Qin, Lihao; Jia, Zhongzhi

doi:10.1200/jco.21.02533

Cited by 7 publications

(8 citation statements)

References 4 publications

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“…Another phase III trial indicated the survival advantage of FOLFOX‐HAIC over TACE in patients with unresectable large HCC (largest diameter ≥7 cm) without macrovascular invasion or extrahepatic spread 11 . Notably, the differences in patient selection and efficacy between HAIC and TACE for HCC management warrant confirmation in future studies 50 …”

Section: Overview Of Locoregional Therapiesmentioning

confidence: 96%

“…11 Notably, the differences in patient selection and efficacy between HAIC and TACE for HCC management warrant confirmation in future studies. 50 HAIC can serve as a treatment option for TACE failure/refractoriness based on liver function and be used to treat HCC with major portal vascular invasion, and intrahepatic multinodular lesions according to CNLC guidelines and JSH consensus statements. 3,5,51 However, no RCT has yet demonstrated a clinical benefit from HAIC in a Western population with HCC.…”

Section: Hepatic Arterial Infusion Chemotherapymentioning

confidence: 99%

“… 11 Notably, the differences in patient selection and efficacy between HAIC and TACE for HCC management warrant confirmation in future studies. 50 …”

Section: Overview Of Locoregional Therapiesmentioning

confidence: 99%

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Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Chen,

Jin,

Zhong

et al. 2024

UEG Journal

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Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of cancer‐related mortality. Locoregional therapies (LRTs) play a crucial role in HCC management and are selectively adopted in real‐world practice across various stages. Choosing the best form of LRTs depends on technical aspects, patient clinical status and tumour characteristics. Previous studies have consistently highlighted the efficacy of combining LRTs with molecular targeted agents in HCC treatment. Recent studies propose that integrating LRTs with immune checkpoint inhibitors and molecular targeted agents could provide substantial therapeutic benefits, a notion underpinned by both basic and clinical evidence. This review summarised the current landscape of LRTs in HCC and discussed the anticipated outcomes of combinations with immunotherapy regimens.

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Section: Overview Of Locoregional Therapiesmentioning

confidence: 96%

Section: Hepatic Arterial Infusion Chemotherapymentioning

confidence: 99%

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Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Chen,

Jin,

Zhong

et al. 2024

UEG Journal

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“…Studies conducted in recent years have shown that the clinical efficacy of HAIC-oxaliplatin is much improved when used as a combination therapy. A head-to-head study of 5-FU, leucovorin and oxaliplatin (FOLFOX)-HAIC vs. TACE also demonstrated a clear advantage of the former in terms of efficacy and safety (14); however, numerous questions remain regarding this study (15,16). Therefore, additional randomized controlled trials (RCTs) are warranted to determine whether the efficacy of HAIC is influenced by the treatment modality or therapeutic regimen.…”

Section: Comparative Effectiveness Of Interventional Therapeutic Moda...mentioning

confidence: 98%

Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis

Chen

Fan

et al. 2022

Oncol Lett

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It is unclear whether hepatic artery infusion chemotherapy (HAIC) or transcatheter arterial chemoembolization (TACE) is more efficient in the combination therapy of hepatocellular carcinoma (HCC). Head-to-head comparisons among HAIC-related therapies are lacking. For this network meta-analysis, PubMed, EMBASE and Cochrane Library databases were searched up to April 1, 2022. Randomized controlled trials (RCTs) were eligible if they evaluated the use or prolongation of TACE or HAIC in patients with advanced HCC and reported or collected survival data. A network meta-analysis was performed to synthesize data and make direct and indirect comparisons between treatments. Hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated to explore the efficacy of various treatment options on overall survival (OS), odds ratios (ORs) with 95% CI were used for overall response rate (ORR), whereas risk ratios (RRs) with 95% CI were used for serious adverse events (SAEs). The analysis of 7 trials including a total of 1,073 patients found that sorafenib with HAIC-oxaliplatin improved survival (HR= 0.33, 95% CI: 0.25-0.44); the ORR was also improved in patients treated with sorafenib plus HAIC-oxaliplatin and sorafenib plus PF-HAIC (OR=22.18, 95% CI: 10. and OR=2.72, respectively). The incidence of liver injury was elevated in patients treated with sorafenib plus TACE (OR=5.93, 95% CI: 2.70-15.41). However, no differences in the incidences of other SAEs were identified among the treatment groups. The present meta-analysis provides preliminary evidence for the comparative safety and efficacy of HAIC and TACE combined with sorafenib, and indicates the dominance of HAIC-oxaliplatin in HCC interventional therapy. However, high-quality RCTs are required to further confirm the efficacy of HAIC-oxaliplatin. The present study has been registered with PROSPERO (registration no. CRD42021288497).

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“…We would like to thank Mei et al 1 for their interest in our study 2 and their thoughtful letter. The authors raised several concerns: (1) The overall survival (OS) and overall response rate (ORR) in our study were inferior to the values in Lencioni's review 3 ; (2) these inferior outcomes may be associated with the heterogeneity and quality of transarterial chemoembolisation (TACE) procedures; and (3) our TACE strategy did not follow the Chinese Clinical Practice Guidelines for TACE of hepatocellular carcinoma.…”

mentioning

confidence: 92%

Reply to J. Mei et al

Lai

et al. 2022

JCO

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We would like to thank Mei et al 1 for their interest in our study 2 and their thoughtful letter. The authors raised several concerns: (1) The overall survival (OS) and overall response rate (ORR) in our study were inferior to the values in Lencioni's review 3 ; (2) these inferior outcomes may be associated with the heterogeneity and quality of transarterial chemoembolisation (TACE) procedures; and (3) our TACE strategy did not follow the Chinese Clinical Practice Guidelines for TACE of hepatocellular carcinoma. 4

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FOLFOX-HAIC for Unresectable Large Hepatocellular Carcinoma: The Effectiveness Has Yet to be Determined

Cited by 7 publications

References 4 publications

Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Comparative effectiveness of interventional therapeutic modalities for unresectable hepatocellular carcinoma: A systematic review and network meta‑analysis

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