Inoperable Hepatocellular Carcinoma: Transarterial<sup>188</sup>Re HDD–Labeled Iodized Oil for Treatment—Prospective Multicenter Clinical Trial

Kumar, Ajay; Srivastava, Deep Narayan; Chau, Trinh Thi Minh; Long, Huynh Duc; Bal, Chandrasekhar; Chandra, Prem; Chien, Le Truong; Hòa, Nguyễn Văn; Thulkar, Sanjay; Sharma, Sanjay; Tam, Le Huu; Xuan, Truong Quang; Canh, Nguyen Xuan; Pant, G S; Bandopadhyaya, Guru

doi:10.1148/radiol.2432051246

Cited by 64 publications

(46 citation statements)

References 19 publications

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“…AFP response was classified into the following: (a) complete response (normalization), (b) partial response (decrease by .50% of the baseline value), (c) [19]. The complications of TACE that occurred within 4 weeks were recorded according to CTCAE [17].TTP was defined as the time from the baseline radiological data to disease progression.…”

Section: Assessmentsmentioning

confidence: 99%

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

et al. 2015

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Background. The survival benefit of combining sorafenib and transarterial chemoembolization (TACE) therapy compared with sorafenib monotherapy for patients with advanced hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT) is unclear. Methods. Between January 2009 and June 2013, 183 consecutive patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) and MPVTT were retrospectively reviewed. Of these, 89 patients with advanced HCC and MPVTT were enrolled in this study: 45 were treated with combination therapy (sorafenib‐TACE group), and the other 44 treated with sorafenib monotherapy (sorafenib group). Results. The mean number of TACE sessions per patient was 2.6 (range: 1–5). The median duration of sorafenib in the sorafenib‐TACE group and sorafenib group was 5.6 months and 5.4 months, respectively. The disease control rate was similar between the two groups. Median time to progression was 3.0 months (95% confidence interval [CI]: 2.2, 3.7) in the sorafenib‐TACE group, and 3.0 months (95% CI: 2.1, 3.8) in the sorafenib group (p = .924). Median overall survival was 7.0 months (95% CI: 6.1, 7.8) and 6.0 months (95% CI: 4.7, 7.3) in the sorafenib‐TACE group and the sorafenib group, respectively (p = .544). The adverse events related to sorafenib were comparable between the two groups. Twenty‐one adverse events of grade 3–4 related to TACE occurred in 12 patients (26.7%), and 2 of them died (4.4%). Conclusion. This study demonstrated no advantage of combination therapy over sorafenib monotherapy. Considering the patients’ morbidity after TACE, sorafenib monotherapy is appropriate for managing patients with advanced HCC and MPVTT. Implications for Practice: For patients with advanced hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT), no benefit was seen in this study in terms of disease control rate, time to progression, and overall survival for patients receiving sorafenib and transarterial chemoembolization compared with those receiving sorafenib monotherapy. Considering the patients’ morbidity after combination therapy, monotherapy is appropriate for managing patients with advanced HCC and MPVTT.

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Section: Assessmentsmentioning

confidence: 99%

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

et al. 2015

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“…a dose escalation study to find the optimum dose has been proposed. 14 two large-scale phase ii studies of 188 re-lipiodol for the treatment of HCC were conducted in developing countries 39,40 and included 93 and 185 patients with advanced disease. Both trials demonstrated that 188 re-lipiodol treatment is feasible and well tolerated.…”

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confidence: 99%

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

Raoul

Boucher

Rolland

et al. 2010

Nat Rev Gastroenterol Hepatol

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Hepatocellular carcinoma (HCC) is becoming an important public health concern. Current therapeutic options are limited and new treatments are therefore being developed. The intra-arterial treatment chemoembolization has limited efficacy and few prospects for further progress. One particularly promising, though little used, alternative to chemoembolization is radioembolization with iodine-131 ((131)I) or rhenium-188 labeled lipiodol or yttrium-90 labeled microspheres (glass or resin beads). Three randomized studies have proven the effectiveness of (131)I-lipiodol in patients with HCC-as adjuvant therapy after surgery, compared with chemoembolization, and also in patients who have portal vein thrombosis. Microspheres enable the delivery of high-dose radiation (>200 Gy) to the tumor while sparing the neighboring hepatic tissue from overexposure. Overall, the efficacy of radioembolization has been good and toxic effects have been low. These results are comparable to those obtained with chemoembolization but further improvement can be expected by combining radioembolization with standard chemotherapy or with targeted therapies, such as anti-angiogenic drugs.

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“…183 In a multicenter trial from India, TART was found to be a safe, effective, and promising therapeutic option in patients with inoperable HCC. 184 However, the availability of Rhennium is a constraint here. Due to logistic limitations and radiation exposure, Yttrium-90 microspheres (Y90) microspheres are currently in use.…”

Section: Role Of Trans-catheter Therapies In Hepatocellular Carcinomamentioning

confidence: 99%

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

Kumar

Acharya

Singh

et al. 2014

Journal of Clinical and Experimental Hepatology

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Inoperable Hepatocellular Carcinoma: Transarterial¹⁸⁸Re HDD–Labeled Iodized Oil for Treatment—Prospective Multicenter Clinical Trial

Abstract: TART appears to be a safe, effective, and promising therapeutic option in patients with inoperable HCC.

Cited by 64 publications

References 19 publications

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

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Inoperable Hepatocellular Carcinoma: Transarterial188Re HDD–Labeled Iodized Oil for Treatment—Prospective Multicenter Clinical Trial

Abstract: TART appears to be a safe, effective, and promising therapeutic option in patients with inoperable HCC.

Cited by 64 publications

References 19 publications

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

Treatment of hepatocellular carcinoma with intra-arterial injection of radionuclides

The Indian National Association for Study of the Liver (INASL) Consensus on Prevention, Diagnosis and Management of Hepatocellular Carcinoma in India: The Puri Recommendations

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Product

Resources

About

Inoperable Hepatocellular Carcinoma: Transarterial¹⁸⁸Re HDD–Labeled Iodized Oil for Treatment—Prospective Multicenter Clinical Trial