Prospective, randomized, controlled study of the efficacy of transcatheter arterial chemoembolization with miriplatin for hepatocellular carcinoma

Kubota, Kousuke; Hidaka, Hiroyoshi; Nakazawa, Takahide; Okuwaki, Yusuke; Yamane, Keiko; Inoue, Takuya; Uojima, Haruki; Takada, Juichi; Tanaka, Yoshiaki; Shibuya, Akitaka; Fujii, Kaoru; Woodhams, Reiko; Matsunaga, Keiji; Kokubu, Shigehiro; Koizumi, Wasaburo

doi:10.1111/hepr.12933

Cited by 7 publications

(6 citation statements)

References 25 publications

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“…37 They reported that the combination therapy of miriplatin and cisplatin had significantly better progression-free survival and overall DCR. Recently, as miriplatin has become the standard drug in addition to anthracyclines in TACE in Japan, [38][39][40] the results of the present study also provide useful basic information whether to add TAI using cisplatin to TACE using miriplatin in the future.…”

Section: Discussionmentioning

confidence: 64%

Transcatheter arterial infusion chemotherapy with cisplatin in combination with transcatheter arterial chemoembolization decreases intrahepatic distant recurrence of unresectable hepatocellular carcinoma

et al. 2021

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Background and Aim: This study investigated the efficacy of transcatheter arterial infusion (TAI) chemotherapy with cisplatin combined with transcatheter arterial chemoembolization (TACE). The goal was to prevent intrahepatic distant recurrence (IDR) of hepatocellular carcinoma (HCC), compared with TACE alone, in patients with unresectable HCC. Methods: We conducted a historical cohort study, which involved 68 unresectable HCC patients. The study was performed on 44 and 24 consecutive patients who underwent TAI using cisplatin combined with TACE using epirubicin and TACE using epirubicin alone, respectively. We performed a propensity score analysis to identify the independent risk factors associated with IDR, and constructed propensity score-adjusted survival curves. Results: After propensity score-adjusting, the adjusted cumulative IDR rates at 1 and 3 years were 76.8 and 76.8% in TACE alone group, and 21.3 and 73.1% in TACE with TAI group, respectively. TACE alone group had a significantly higher IDR rate in comparison with TACE with TAI group (P = 0.0073). Combined with TAI was associated with preventing IDR after propensity score-adjusting (hazard ratio [HR] 0.40, 95% confidence intervals [CI] 0.17-0.91, P = 0.028). Combined with TAI (HR 0.26, 95% CI 0.10-0.68, P = 0.0056) and Stage ≥III (HR 2.98, 95% CI 1.25-7.12, P = 0.014) were independent IDR predictors after adjusting for significant risk factors with propensity score. Conclusions: We demonstrated that cisplatin TAI accompanied with TACE decreased IDR compared with TACE alone. Our findings suggest that cisplatin TAI might contribute to a longer progression-free period in unresectable HCC patients treated with TACE.

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Section: Discussionmentioning

confidence: 64%

Transcatheter arterial infusion chemotherapy with cisplatin in combination with transcatheter arterial chemoembolization decreases intrahepatic distant recurrence of unresectable hepatocellular carcinoma

et al. 2021

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“…Transcatheter arterial therapy, including TACE and TAI using lipiodol and anticancer agents, is widely used to treat HCC (17). In TACE, we administer anticancer agents and embolize the tumor nutrient arteries using gelatin sponge particles.…”

Section: Discussionmentioning

confidence: 99%

“…In October 2009, miriplatin, belonging to the family of platinum agents, was approved as a TACE agent for treating HCC. The results of several previous studies on TACE using miriplatin suggest that miriplatin may be one of the safest and most efficacious therapeutic agents (1,6,17). However, TACE is not recommended in patients with distant metastases and vascular invasion.…”

Section: Discussionmentioning

confidence: 99%

Acute Exacerbation of Idiopathic Interstitial Pneumonia in a Patient with Hepatocellular Carcinoma after Transcatheter Arterial Therapy Using Miriplatin

et al. 2019

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A 76-year-old Japanese woman with recurrent hepatocellular carcinoma presented with acute exacerbation of idiopathic interstitial pneumonia (AE-IIP) after transcatheter arterial therapy using miriplatin. She had a history of preexisting IIP five years before presenting at our hospital. On day 4 after transcatheter arterial therapy, she complained of shortness of breath. Subsequently, she developed acute respiratory failure on day 11 after transcatheter arterial therapy. Chest computed tomography revealed extensive ground-glass opacity and traction bronchiectasis in bilateral lung fields; subsequently, she was diagnosed with AE-IIP triggered by transcatheter arterial therapy using miriplatin. Despite systemic administration of high-dose corticosteroid and cyclophosphamide, she died of respiratory failure on day 36.

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“…Until recently, a total of 12 retrospective and prospective reports have been published regarding miriplatin compared with other anticancer drugs in the treatment of TACE (Table ). Although miriplatin seemed to have an ideal chemical and pharmacological structure in lipiodol‐using TACE, Miyayama et al reported that the anticancer activity was not higher than conventional TACE using ordinary epirubicin.…”

Section: Transcatheter Arterial Therapymentioning

confidence: 99%

“…As the viscosity of miriplatin–lipiodol suspension is higher than lipiodol alone, it hardly flows into the peripheral hepatic artery compared with other emulsified anticancer drugs. We should realize the efficiency of the use of warmed miriplatin suspension at transcatheter arterial injection: two retrospective comparisons showed the objective response rates of warmed miriplatin were higher and one prospective study showed a longer time to tumor progression . Miriplatin is currently used for non‐selective infusion for bilobar multiple HCCs, epirubicin‐refractory HCC, and for targeted balloon‐occluded TACE (B‐TACE) against localized HCCs, but ideal use of warming and ways of injection are not fully elucidated.…”

Section: Transcatheter Arterial Therapymentioning

confidence: 99%

Recent advances in medical management of hepatocellular carcinoma

Ikeda

2018

Hepatology Research

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Transcatheter arterial therapies for hepatocellular carcinoma (HCC) have developed during the last decade. A fine powder formulation of cisplatin and the new platinum agent miriplatin became standard medicines in addition to anthracyclines in transcatheter arterial chemoembolization (TACE) in Japan. Recent prospective and retrospective studies supported the usefulness of platinum agents as a chemotherapeutic at the time of varied TACE therapy. Although balloon-occluded TACE is an effective therapy for localized HCC and drug-eluting microspheres seemed to show a higher response rate in certain HCCs, the definite advantages of those procedures still remain uncertain. Intermediate stage HCC, or Barcelona Clinic Liver Cancer stage B, is regarded as a heterogeneous category with a wide spectrum of tumors and patients, and several subclassifications of the stage have been proposed to show different prognoses; there are also different recommended therapies in each subgroup. Authors have subclassified patients based on combinations of tumor size, tumor number, and liver function, with or without performance status. Because of differences of available medical resources and techniques in treatment procedures between countries, the most ideal and useful subgrouping remains inconclusive at present. Recently, a few systemic chemotherapies proved to be effective for advanced stage HCC in phase III studies: lenvatinib as the first line of therapy, and regorafenib, cabozantinib, and ramucirumab as second-line therapy. Other molecular-targeted and immune-oncological medicines are expected to follow in the near future. Some studies have suggested an advantage of early introduction of moleculartargeted therapy for TACE-resistant HCC in the intermediate stage.

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Prospective, randomized, controlled study of the efficacy of transcatheter arterial chemoembolization with miriplatin for hepatocellular carcinoma

Abstract: Miriplatin proved more effective than epirubicin in TACE for unresectable HCC. The trial described in this work has been registered under the trial number: UMIN000004790.

Cited by 7 publications

References 25 publications

Transcatheter arterial infusion chemotherapy with cisplatin in combination with transcatheter arterial chemoembolization decreases intrahepatic distant recurrence of unresectable hepatocellular carcinoma

Transcatheter arterial infusion chemotherapy with cisplatin in combination with transcatheter arterial chemoembolization decreases intrahepatic distant recurrence of unresectable hepatocellular carcinoma

Acute Exacerbation of Idiopathic Interstitial Pneumonia in a Patient with Hepatocellular Carcinoma after Transcatheter Arterial Therapy Using Miriplatin

Recent advances in medical management of hepatocellular carcinoma

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