Intermediate hepatocellular carcinoma: the role of transarterial therapy

Chegai, Fabrizio; Orlacchio, Antonio; Merolla, Stefano; Monti, Serena; Mannelli, Lorenzo

doi:10.2217/hep.15.32

Cited by 12 publications

(11 citation statements)

References 84 publications

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“…This can be explained by the use of intra-arterial injection and the fact that liver tumors are irrigated mostly by the arteries whereas healthy parenchyma is irrigated by the venous system [ 12 – 15 ]. In the rat (n°1) no change in the blood supply occurred since no carcinogenesis developed [ 63 ]. This explains the homogeneous distribution of the particles observed in the liver.…”

Section: Discussionmentioning

confidence: 99%

68Ga and 188Re Starch-Based Microparticles as Theranostic Tool for the Hepatocellular Carcinoma: Radiolabeling and Preliminary In Vivo Rat Studies

et al. 2016

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PurposeThis work aims to develop, validate and optimize the radiolabeling of Starch-Based Microparticles (SBMP) by 188Re and 68Ga in the form of ready-to-use radiolabeling kits, the ultimate goal being to obtain a unique theranostic vector for the treatment of Hepatocellular Carcinoma.MethodsOptimal labeling conditions and composition of freeze-dried kits were defined by monitoring the radiochemical purity while varying several parameters. In vitro stability studies were carried out, as well as an in vivo biodistribution as a preliminary approach with the intra-arterial injection of 68Ga radiolabeled SBMP into the hepatic artery of DENA-induced rats followed by PET/CT imaging.ResultsKits were optimized for 188Re and 68Ga with high and stable radiochemical purity (>95% and >98% respectively). The in vivo preliminary study was successful with more than 95% of activity found in the liver and mostly in the tumorous part.ConclusionSBMP are a promising theranostic agent for the Selective Internal Radiation Therapy of Hepatocellular carcinoma.

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Section: Discussionmentioning

confidence: 99%

68Ga and 188Re Starch-Based Microparticles as Theranostic Tool for the Hepatocellular Carcinoma: Radiolabeling and Preliminary In Vivo Rat Studies

et al. 2016

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“…TAE is an invasive technique widely applied in the clinical setting, especially when, for example, liver metastasis occurs resulting in a tumor size of >3 cm, at which point the patient can neither undergo surgical procedure nor adjuvant chemotherapy (equivalent to Stage B in Barcelona Clinic Liver Cancer staging system) 3 . Taking the role of transarterial embolization (TAE) in the treatment of hepatocellular carcinoma (HCC) as an example, the underlying principle of TAE is described as follows 4 . The liver has a unique dual blood supply from both the portal vein and the hepatic artery.…”

Section: Introductionmentioning

confidence: 99%

Hyaluronic acid-based nano-sized drug carrier-containing Gellan gum microspheres as potential multifunctional embolic agent

Hsu

Tyan

Chien

et al. 2018

Sci Rep

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The purpose of this study was to develop a gellan gum-based multifunctional embolic agent. Calibrated spherical gellan gum and nanoparticle-containing gellan gum microspheres were prepared via water-in oil emulsification method. Self-assembled nanoparticles composed of short-chain hyaluronic acid and polyethylenimine as the doxorubicin carrier were prepared. The short-chain hyaluronic acid/polyethylenimine/ doxorubicin (sHH/PH/Dox) with the mean size was 140 ± 8 nm. To examine sHH/PH/Dox nanoparticle uptake into cells, the results confirmed that sHH/PH nanoparticles as drug carrier can facilitate the transport of doxorubicin into HepG2 liver cancer cells. Subsequently, sHH/PH/Dox merged into the gellan gum (GG) microspheres forming GG/sHH/PH/Dox microsphere. After a drug release experiment lasting 45 days, the amount of released doxorubicin from 285, 388, and 481 μm GG/sHH/PH/Dox microspheres were approximately 4.8, 1.8 and 1.1-fold above the IC50 value of the HepG2 cell. GG/sHH/PH/Dox microspheres were performed in rabbit ear embolization model and ischemic necrosis on ear was visible due to the vascular after 8 days. Regarding the application of this device in the future, we aim to provide better embolization agents for transcatheter arterial chemoembolization (TACE).

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“…Conventional-TACE (cTACE) (using chemotherapeutic drugs with or without Lipiodol and the administration of embolic agents) is the most widespread technique and allows both to increase intratumoral retention of chemotherapy agent and to induce ischemic tumor necrosis through a transient occlusion of tumor feeding arteries [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Repeated Transarterial Chemoembolization with Degradable Starch Microspheres (DSMs-TACE) of Unresectable Hepatocellular Carcinoma: A Prospective Pilot Study

Orlacchio

Chegai

Francioso

et al. 2018

CMIR

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Objective: The aims of this study were to: a) evaluate tumor response rates using modified-Response-evaluation-criteria-in-solid-tumors (mRecist) criteria, b) evaluate safety of Degradable Starch Microspheres Trans-arterial-chemo-embolization (DSMs-TACE) for unresectable hepatocellular-carcinoma (HCC) treatment.Materials and Methods: We prospectively enrolled 24 HCC cirrhotic patients (21/3 M/F, mean age 66.3 years) to be treated with repeated DSMs-TACE procedures, performed at 4-6 week intervals on the basis of tumor response and patients tolerance. Clinical and biochemical evaluations were performed before and after each procedure. Treatment response was also assessed by Computed-tomography (CT) or Magnetic-resonance-imaging (MRI)-scan 4-6 weeks following each procedure.Results: In our experience, DSMs-TACE was both safe and effective. A total of 53 DSMs-TACE procedures were performed (2.2 per patient). No procedure-related death was observed. Complete Response (CR) was observed in 5/24 (20.8%), 4/17 (23.5%) and 5/12 (41.6%) patients after the first, second and third procedure, respectively. At the end of each treatment, all patients experienced at least a partial response. At the end of the repeated procedures, no differences between mono- or bi-lobar disease were observed in patients with CR (64.2% vs 50%; p=ns). In most cases, treatment discontinuation was due to worsening liver function.Conclusion: DSMs-TACE is a valid, well-tolerated alternative treatment to Lipiodol-TACE or DEB-TACE, as it has demonstrated to achieve a relatively high percentage of complete tumor necrosis.CR rates were similar between patients with mono- or bi-lobar disease indicating the possibility of carrying-out repeated procedure in a safe and effective way in both types of patients.

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Intermediate hepatocellular carcinoma: the role of transarterial therapy

Cited by 12 publications

References 84 publications

68Ga and 188Re Starch-Based Microparticles as Theranostic Tool for the Hepatocellular Carcinoma: Radiolabeling and Preliminary In Vivo Rat Studies

68Ga and 188Re Starch-Based Microparticles as Theranostic Tool for the Hepatocellular Carcinoma: Radiolabeling and Preliminary In Vivo Rat Studies

Hyaluronic acid-based nano-sized drug carrier-containing Gellan gum microspheres as potential multifunctional embolic agent

Repeated Transarterial Chemoembolization with Degradable Starch Microspheres (DSMs-TACE) of Unresectable Hepatocellular Carcinoma: A Prospective Pilot Study

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