Hepatic Arterial Infusion Chemotherapy versus Sorafenib in Patients with Advanced Hepatocellular Carcinoma

Ueshima, Kazuomi; Ogasawara, Sadahisa; Ikeda, Masafumi; Yasui, Yutaka; Terashima, Toshio; Yamashita, Tatsuya; Obi, Shuntaro; Sato, Shinpei; Aikata, Hiroshi; Ohmura, Takumi; Kuroda, Hidekatsu; Ohki, Takamasa; Nagashima, Kengo; Ooka, Yoshihiko; Takita, Masahiro; Kurosaki, Masayuki; Chayama, Kazuaki; Kaneko, Shuichi; Izumi, Namiki; Kato, Naoya; Kudo, Masatoshi; Omata, Masao

doi:10.1159/000508724

Cited by 87 publications

(78 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“… 6 , 9–11 Although HAIC had many benefits, it showed unsatisfying control ability on extrahepatic metastases, indicating the efficacy remains limited and needs to be further improved. 12 …”

Section: Introductionmentioning

confidence: 99%

“…6,[9][10][11] Although HAIC had many benefits, it showed unsatisfying control ability on extrahepatic metastases, indicating the efficacy remains limited and needs to be further improved. 12 Programmed cell death protein-1 (PD-1) inhibitors are currently the focus of cancer research. The survival benefit of PD-1 inhibitors in unresectable HCC patients is beyond borders, with a median OS of 13.9-15.6 months, and its treatment-related toxic effects are relatively low.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

Mei¹,

Li²,

Li³

et al. 2021

JHC

View full text Add to dashboard Cite

Background Hepatic artery infusion chemotherapy (HAIC) and anti-programmed cell death protein-1 (PD-1) immunotherapy have shown promising outcomes in patients with advanced hepatocellular carcinoma (HCC), respectively. However, the combination of the two treatments has not been reported. In this study, we compared the efficacy of HAIC combined with anti-PD-1 immunotherapy (HAICAP) and HAIC in patients with advanced HCC. Methods Between November 2018 and December 2019, advanced HCC patients that were treated with either HAICAP or HAIC were retrospectively recruited and reviewed for eligibility. Efficacy was evaluated according to tumor response and survival. Results As a result, 229 patients were included in this study. Patients were divided into HAICAP group (n = 81) and HAIC group (n = 148) accordingly. The follow-up time ranged from 1.0 to 21.6 months, with a median of 11.0 months. The median overall survival was 18.0 months in the HAICAP group and 14.6 months in the HAIC group (p = 0.018; HR = 0.62; 95% CI 0.34–0.91). The median progression-free survival was 10.0 months in the HAICAP group and 5.6 months in the HAIC group (p = 0.006; HR = 0.65; 95% CI 0.43–0.87). The disease control rate in overall response (83% vs 66%; p = 0.006) and intrahepatic response (85% vs 74%, respectively; p = 0.045) were higher in the HAICAP group than in the HAIC group. Conclusion In comparison to HAIC, HAICAP was associated with a better treatment response and survival benefits for patients with advanced HCC.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

Mei¹,

Li²,

Li³

et al. 2021

JHC

View full text Add to dashboard Cite

show abstract

“…In Child-Pugh A or B HCC patients with portal vein tumor thrombus, the MST was similarly significantly longer in patients receiving HAIC (7.9 months) than in those without therapy (3.1 months) [23]. A recent report demonstrated that none of the HAIC regimens (low-dose FP, FAIT, and CDDP alone) had no effect on survival in patients with advanced HCC [11].…”

Section: Clinical Outcomesmentioning

confidence: 98%

“…In contrast, hepatic arterial infusion chemotherapy (HAIC), which has been performed since the 1990s in Japan, may be a candidate for addressing an unmet medical need. Although several studies showed the efficacy of HAIC in a subpopulation of patients with advanced HCC [11][12][13][14][15][16][17], various guidelines from Asia, Europe, and the US do not recommend HAIC as a treatment option for advanced HCC due to low evidence levels, except for the Japanese guideline [18][19][20][21]. In addition, technical difficulties and medical care are needed to institute and maintain the reservoir system.…”

Section: Introductionmentioning

confidence: 99%

Clinical Benefits of Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

et al. 2021

View full text Add to dashboard Cite

Recent success of systemic therapeutic agents, including combination immunotherapy, could promote a change in the treatment strategy in patients with advanced hepatocellular carcinoma (HCC). Although hepatic arterial infusion chemotherapy (HAIC) is a treatment option for advanced HCC in Japan, it is not recommended by other guidelines. We discuss the clinical benefits of HAIC compared to sorafenib. The clinical benefits of HAIC are as follows: 1) even a patient with Child–Pugh B HCC (7 or 8 points) is a candidate for HAIC; 2) Child–Pugh scores barely decline with the use of HAIC compared with sorafenib; 3) HAIC is highly effective in patients with vascular invasion compared with sorafenib; and 4) survival in patients receiving HAIC may not be associated with skeletal muscle volume. In contrast, the disadvantages are problems related with the reservoir system. HAIC has clinical benefits in a subpopulation of patients without extrahepatic metastasis with Child–Pugh A HCC and vascular invasion (especially primary branch invasion or main portal vein invasion) or with Child–Pugh B HCC.

show abstract

“…All of the targeted therapy and immune checkpoint inhibitors are effective for vascular invasion in the pivotal studies [4, 5, 16, 17, 19, 25, 28, 29, 70, 71]. However, hepatic arterial infusion chemotherapy can be an alternative treatment modality for major vascular invasion even in elderly patients or in patients with Child-Pugh B liver function [13, 93, 94].…”

Section: Systemic Therapy In Patients With Macrovascular Invasionmentioning

confidence: 99%

Recent Advances in Systemic Therapy for Hepatocellular Carcinoma in an Aging Society: 2020 Update

Kudo¹

2020

Liver Cancer

Self Cite

View full text Add to dashboard Cite

Systemic therapy for hepatocellular carcinoma (HCC) has changed markedly since the introduction of the molecular targeted agent sorafenib in 2007. Sorafenib increased the available treatment options for patients with extrahepatic spread and vascular invasion and improved survival in patients with advanced HCC; however, various shortcomings such as low response rates and relatively high toxicity (e.g., hand-foot skin reaction) prompted concerted efforts aimed at developing new molecular targeted agents to provide more treatment options and second-line agents for patients with disease progression or intolerance to sorafenib. Despite many attempts to develop new drugs between 2007 and 2016, all first-line and second-line clinical trials conducted during this period failed. However, between 2017 and 2019, 4 drugs (lenvatinib as a first-line agent and regorafenib, cabozantinib, and ramucirumab as second-line agents) emerged in quick succession from clinical trials and became available for clinical use. In addition, nivolumab and pembrolizumab were approved as second-line agents after sorafenib. A recent phase III trial (IMbrave150) showed that combination immunotherapy with atezolizumab plus bevacizumab increases overall survival compared with sorafenib therapy; Food and Drug Agency already approved this combination therapy, and worldwide approval is expected soon. This review describes the recent advances in systemic therapy and the use of tyrosine kinase inhibitors (sorafenib, lenvatinib, regorafenib, and cabozantinib), monoclonal antibodies (ramucirumab and bevacizumab), and immune checkpoint inhibitors (nivolumab, pembrolizumab, and atezolizumab) in elderly patients and the similarity of their efficacy and safety profiles to those in the general population.

show abstract

Hepatic Arterial Infusion Chemotherapy versus Sorafenib in Patients with Advanced Hepatocellular Carcinoma

Abstract: Background: Prior to the approval of sorafenib, hepatic arterial infusion chemotherapy (HAIC) was offered to patients with advanced hepatocellular carcinoma (HCC) in East Asia, particularly Japan. According to the Japanese guidelines, HAIC is recommended as one of the treat

Cited by 87 publications

References 30 publications

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

Clinical Benefits of Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

Recent Advances in Systemic Therapy for Hepatocellular Carcinoma in an Aging Society: 2020 Update

Contact Info

Product

Resources

About