Gemcitabine plus oxaliplatin in advanced hepatocellular carcinoma: A large multicenter AGEO study

Zaanan, Aziz; Williet, Nicolas; Hebbar, Mohamed; Dabakuyo, Tienhan Sandrine; Fartoux, Lætitia; Mansourbakht, T.; Dubreuil, Olivier; Rosmorduc, Olivier; Cattan, Stéphane; Bonnetain, Franck; Boige, Valérie; Taı̈eb, Julien

doi:10.1016/j.jhep.2012.09.006

Cited by 95 publications

(81 citation statements)

References 31 publications

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“…Currently, an oxaliplatin-based regimen is widely used in China and other countries [23,[49][50][51][52]. Oxaliplatin was approved by the China Food and Drug Administration for the systemic chemotherapy of HCC on March 12, 2013, and the FOLFOX4 regimen was included in the "Diagnosis and Treatment Guideline of Primary Liver Cancer" published by the China Ministry of Health on October 24, 2011.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of the FOLFOX4 Regimen Versus Doxorubicin in Chinese Patients With Advanced Hepatocellular Carcinoma: A Subgroup Analysis of the EACH Study

et al. 2014

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Background. The EACH study assessed the efficacy of oxaliplatin, 5-fluorouracil, and leucovorin (the FOLFOX4 regimen) compared with doxorubicin alone in terms of overall survival (OS), progression-free survival (PFS), and safety in patients with advanced hepatocellular carcinoma (HCC). We present the results of this study in Chinese patients. Methods. In a multicenter, open-label, randomized, phase III study (NCT00471965), 371 patients (279 patients from the People's Republic of China) were randomized 1:1 to receive either FOLFOX4 or doxorubicin until disease progression, intolerable toxicity, death, or surgical resection. Results. Baseline characteristics of the Chinese patients enrolled in the study were similar for the 2 treatment groups and in comparison with the whole EACH cohort. Median OS at the prespecified time point of treatment was 5.7 months with FOLFOX4 and 4.3 months with doxorubicin (hazard ratio [HR]:

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Section: Discussionmentioning

confidence: 99%

Efficacy and Safety of the FOLFOX4 Regimen Versus Doxorubicin in Chinese Patients With Advanced Hepatocellular Carcinoma: A Subgroup Analysis of the EACH Study

et al. 2014

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“…Recently, the development of novel chemotherapy drugs such as Oxaliplatin, Capecitabine, and Gemcitabine among others has facilitated the development of systemic chemotherapy regimens for the treatment of HCC. However, this approach has so far only demonstrated modest improvements in outcomes, including an mOS of 6.47-12.2 months in the treatment of advanced HCC (17)(18)(19).…”

Section: Efficacy Of Retronectin-activated Cytokine-induced Killer Cementioning

confidence: 99%

Efficacy of RetroNectin-activated cytokine-induced killer cell therapy in the treatment of advanced hepatocelluar carcinoma

Wang

Kellner

et al. 2016

Oncology Letters

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Abstract. The present study aimed to investigate the efficacy of RetroNectin-activated cytokine-induced killer cell (R-CIK) therapy in advanced hepatocellular carcinoma patients as compared with conventional chemotherapy, a comparison that has not yet been thoroughly studied. From January 2010 to October 2013, 74 patients with an initial diagnosis of advanced hepatocelluar carcinoma were enrolled in the study. Patients were assigned to one of two treatment arms: patients in arm 1 (n=37) received R-CIK treatment as the first line therapy, whereas those in arm 2 (n=37) received chemotherapy as the first line treatment. The primary end point measured in this study was median overall survival (mOS). Median progression-free survival time (mPFS) and 1-and 2-year survival rates were recorded as secondary end points. Kaplan-Meier analysis was performed on all mOS and mPFS data, and treatment hazard ratios were established using the Cox proportional hazards model. The 1-year survival rate in treatment arm 1 was 42.47% vs. 24.89% in arm 2 (95% CI, 24.91-59.01% vs. 12.10-40.02%, P=0.066); the 2-year survival rates were 21.24 and 5.53% (95% CI, 4.60-45.86 vs. 0.46-21.06%, P= 0.106) in arms 1 and 2, respectively; the mPFS in arm 1 was 4.37 vs. 3.90 (x 2 = 0.182, P=0.670) in arm 2; and the mOS in arm 1 was 14.03 months vs. 9.46 months(x 2 =4.406, P=0.036) in arm 2. Calculations of univariate analyses of arm 1, R-CIK cycles ≥6, KPS >70, AFP ≤400 ng/ml, and findings of no vascular invasion and no extra-hepatic metastasis were potential predictive factors (P<0.05). Calculations from multivariate analyses similarly identified these factors as potentially having predictive value (P<0.05). The main adverse effects of R-CIK therapy included fever and headache pain. R-CIK treatment may prolong mOS in advanced hepatocellular carcinoma patients compared with conventional chemotherapy. Patients who underwent ≥6 cycles of R-CIK, had KPS scores >70, AFP ≤400 ng/ml, displayed no evidence of vascular invasion, and no extra-hepatic metastasis appeared to have longer survival times compared with other cohorts in the present study.

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“…Resection techniques have been refined, from the use of new radiofrequency ablation resection devices to laparoscopic approaches, both showing to diminished blood loss [1,2] . A recent meta-analysis showed that laparoscopic approach decreases blood loss, transfusion requirement, postoperative morbidity, recovery time, and hospital stay compared to open-surgery, but with no difference in recurrence or survival [28] .…”

Section: Ng Standardmentioning

confidence: 99%

“…The gemcitabine plus oxaliplatin (GEMOX) regimen appeared to be the most promising, based on its lack of renal and hepatic toxicity in patients with underlying cirrhosis and its interesting efficacy in phase II trials [95][96][97] . The largest multicenter study suggested that GEMOX is effective with an acceptable profile of safety; the induced tumor response allowed a secondary local therapy option that was not initially feasible in a significant proportion of patients, which suggests that it could be indicated as a first line treatment for patients who may particularly benefit from tumor downsizing [2] . GEMOX may be a therapeutic option after sorafenib discontinuation in the absence of a validated second line treatment.…”

Section: Chemotherapymentioning

confidence: 99%

“…Hepatocellular carcinoma (HCC) is a major global health problem, being the primary malignancy of the liver (represents more than 90% of primary liver cancers), one of the most common tumors worldwide and one of the fastest growing causes of cancer-related death [1,2] . The most recent data shows that HCC is the seventh most common cancer (5.6% of all cases) and the second cause of cancer-related death (9.1% of all cases) worldwide.…”

Section: Introductionmentioning

confidence: 99%

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Hepatocellular carcinoma treatment strategies – a case-based review

Alves

Gomes

Macedo

et al. 2015

JST

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Hepatocellular carcinoma (HCC) is one of the most common tumors worldwide and one of the fastest growing causes of cancer-related mortality, being mostly diagnosed in patients with cirrhosis. Despite the recent efforts regarding an earlier diagnosis, the majority of patients are at advanced stages at first presentation, when the potential for institution of curative strategies is scarce. This tumor is remarkable because it occurs mostly superimposed on chronic liver diseases, which entails the need to take special attention to liver function preservation and hepatotoxicity prevention when choosing a specific therapy. Major changes had occurred in the management of HCC in the last decade. The decision-making process must be based on an accurate staging of the patient, using the Barcelona Clinic Liver Cancer (BCLC) staging system, updated knowledge of the new therapeutic options, their contraindications and the potential local or systemic complications. The authors start from 4 clinical different scenarios, in order to objectively discuss the therapeutic options available and the decision-making-process based on the staging system.

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Gemcitabine plus oxaliplatin in advanced hepatocellular carcinoma: A large multicenter AGEO study

Cited by 95 publications

References 31 publications

Efficacy and Safety of the FOLFOX4 Regimen Versus Doxorubicin in Chinese Patients With Advanced Hepatocellular Carcinoma: A Subgroup Analysis of the EACH Study

Efficacy and Safety of the FOLFOX4 Regimen Versus Doxorubicin in Chinese Patients With Advanced Hepatocellular Carcinoma: A Subgroup Analysis of the EACH Study

Efficacy of RetroNectin-activated cytokine-induced killer cell therapy in the treatment of advanced hepatocelluar carcinoma

Hepatocellular carcinoma treatment strategies – a case-based review

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