Multicentre prospective study of drug-eluting bead chemoembolisation safety using tightly calibrated small microspheres in non-resectable hepatocellular carcinoma

Urbano, José; Echevarria-Uraga, José Javier; Ciampi-Dopazo, Juan José; Sánchez-Corral, Juan A.; Alonso, Jorge Cobos; Antón-Ladislao, Ane; Peña-Baranda, Borja; Nacarino-Mejías, Verónica; González-Costero, Rocío; Ruiz-Canela, J. J. Muñoz; Pérez-Cuesta, Julian; Lanciego, Carlos; Gregorio, M.A. de

doi:10.1016/j.ejrad.2020.108966

Cited by 23 publications

(29 citation statements)

References 34 publications

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“…Urbano et al conducted a prospective multicenter study in Spain, including 131 patients with liver cancer receiving 214 times of D‐TACE treatment. The objective remission rates at 6 months, 1 year, and 2 years were 74.6%, 45.7%, and 44.1%, respectively 24 . In this study, CalliSpheres microspheres loaded with epirubicin hydrochloride were used for arterial embolization, and the curative effect was evaluated using the mRECIST standard.…”

Section: Discussionmentioning

confidence: 98%

“…The objective remission rates at 6 months, 1 year, and 2 years were 74.6%, 45.7%, and 44.1%, respectively. 24 In this study, CalliSpheres microspheres loaded with epirubicin hydrochloride were used for arterial embolization, and the curative effect was evaluated using the mRECIST standard. The ORR and DCR of 1, 3, and 6 months were 69%, 59.6%, 33.3%, and 91.5%, 91.5%, and 73.8%, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Drug‐eluting bead transarterial chemoembolization with medium‐sized versus small‐sized CalliSpheres microspheres in unresectable primary liver cancer

Zhang

Guo²,

et al. 2021

Asia-Pac J Clncl Oncology

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Purpose The optimal microparticle size for drug‐eluting beads transarterial chemoembolization (DEB‐TACE) remains unknown. This retrospective cohort study analyzed the efficacy and safety of CalliSpheres microsphere embolization in the treatment of unresectable hepatocellular carcinoma (HCC) to determine the influence of particle size on the results. Patients and methods Forty‐two patients with unresectable HCC were enrolled in this retrospective study from January 2018 to January 2020. Patients received DEB‐TACE with CalliSpheres of 100–300 μm (small‐size, n = 15) or 300–500 μm (medium‐size, n = 27). The tumor response was evaluated via enhanced CT or MRI at 1 month, 3 months, and 6 months after treatment, based on the Modified Response Evaluation Criteria in Solid Tumors. Adverse events after DEB‐TACE were recorded. Results Complete response, partial response, stable disease, and progressive disease were recorded in 20%, 20%, 33.3%, 26.7%, respectively, of patients in the small‐size group and 3.7%, 25.9%, 44.4%, 25.9% of patients in the medium‐size group, respectively. No significant difference was found between the two groups (p = 0.516). Major adverse events, including grade three liver toxicity (n = 4) and liver abscess (n = 3), occurred significantly more in the small‐size group, while none were reported in the medium size group (p < 0.05). Conclusion DEB‐TACE with medium‐size (300–500 μm) CalliSpheres microspheres had similar efficacy and a better safety profile than DEB‐TACE with small‐size (100–300 μm) CalliSpheres, indicating that medium‐size microspheres may be a better choice for unresectable primary liver cancer.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Drug‐eluting bead transarterial chemoembolization with medium‐sized versus small‐sized CalliSpheres microspheres in unresectable primary liver cancer

Zhang

Guo²,

et al. 2021

Asia-Pac J Clncl Oncology

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“…In our study, however, no biliary damage after the procedure was recorded, and significant deterioration of liver function (≥2 points in Child-Pugh score) was rare and exceptional. Recent studies on small DEB particles have reported biliary complication rates of 0%-6.8% and described most complications as asymptomatic [29,30]. Therefore, biliary toxicity may not be related to the DEB particle size; it may be related to the position of the microcatheter and the embolization endpoint [20,31].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Clinical Efficacy and Safety between 70–150 µm and 100–300 µm Doxorubicin Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

Hong

Kim

et al. 2022

Life

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Background: This study aimed to compare the efficacy and safety of 70–150 μm doxorubicin drug-eluting bead (DEB) transarterial chemoembolization (TACE) with those of 100–300 μm DEB-TACE as first-line treatment in patients with hepatocellular carcinoma (HCC). Methods: We retrospectively investigated 72 patients who underwent TACE with 70–150 μm DEBs (n = 40) or 100–300 μm DEBs (n = 32) for HCC in a tertiary center between March 2013 and May 2019. Initial treatment response and adverse events were assessed using the modified Response Evaluation Criteria in Solid Tumors and the National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0, respectively. Results: At the 2-month post-treatment assessment, the complete and objective response rates were 47.5% and 85.0%, respectively, for the 70–150 μm group and 34.4% and 81.3%, respectively, for the 100–300 μm group; however, the difference was not statistically significant (p > 0.05). In total, 65% patients in the 70–150 μm group and 59.4 % patients in the 100-300 μm group experienced at least one symptom of post-embolization syndrome after TACE; all symptoms were classified as grade 1 or 2. There was no significant difference between the two groups in terms of post-procedural laboratory changes such as changes in liver enzymes and bilirubin levels (p > 0.05). Laboratory toxicity of grade 3 occurred in three patients, all of which were transient elevation of liver enzyme levels. Hepatobiliary adverse events, such as bile duct injury, biloma, liver abscess, and hepatic infarction, were not observed in either treatment group. Conclusion: This study found no significant difference in tumor response between 70–150 μm and 100–300 μm DEB-TACE. Both groups showed favorable safety profiles, and the difference was not significant.

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“…For limited disease within the Milan criteria, the treatment strategy needs to include escalation of the doxorubicin dose up to 75 mg per single TACE. For advanced disease exceeding the Milan criteria, the doxorubicin dose could be to a maximum of 150 mg. 14,15 Univariate analysis of Urbano et al 16 found a significant association between complications and the administered dose of doxorubicin. 52% of minor complications and 71% of major complications occurred in the group of patients who received the maximal dose of doxorubicin.…”

Section: Doxorubicin Loading and Planned Dosementioning

confidence: 99%

“…Complications were not associated with Child-Pugh score, Barcelona Clinic Liver Cancer (BCLC) stage, selective or super-selective catheterization, co-morbidities, or treatment response. 16 Galastri et al 17 calculated the dose ratio in all HCCs of the chemoembolic agent/cm of viable HCC until vascular stasis is reached and concluded that the amount of chemoembolic agent increases the chance of an ORR in HCC and increases the percentage of tumor necrosis.…”

Section: Doxorubicin Loading and Planned Dosementioning

confidence: 99%

The update on transcatheter arterial chemoembolization using drug-eluting beads: Optimization for best response

Chun

2021

Int J Gastrointest Interv

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Multicentre prospective study of drug-eluting bead chemoembolisation safety using tightly calibrated small microspheres in non-resectable hepatocellular carcinoma

Cited by 23 publications

References 34 publications

Drug‐eluting bead transarterial chemoembolization with medium‐sized versus small‐sized CalliSpheres microspheres in unresectable primary liver cancer

Drug‐eluting bead transarterial chemoembolization with medium‐sized versus small‐sized CalliSpheres microspheres in unresectable primary liver cancer

Comparison of Clinical Efficacy and Safety between 70–150 µm and 100–300 µm Doxorubicin Drug-Eluting Bead Transarterial Chemoembolization for Hepatocellular Carcinoma

The update on transcatheter arterial chemoembolization using drug-eluting beads: Optimization for best response

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