Transarterial Chemoembolization for Hepatocellular Carcinoma with Drug-Eluting Microspheres: Preliminary Results from an Italian Multicentre Study

Grosso, Maurizio; Vignali, C; Quaretti, Pietro; Nicolini, Antonio; Melchiorre, Fabio; Gallarato, G.; Bargellini, Irene; Petruzzi, P; Saluzzo, Cesare Massa; Crespi, S.; Sarti, I

doi:10.1007/s00270-008-9409-2

Cited by 117 publications

(81 citation statements)

References 21 publications

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“…Regarding the use of HepaSphere, few data on HCC patients are available but a similar response rate of 51% at 6 months was reported in a multicenter study [60].…”

Section: Technical Considerationssupporting

confidence: 53%

Locoregional Transarterial Therapies for Hepatocellular Carcinoma: Transarterial Chemoembolization and Radioembolization

2013

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Background: Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the third most common cause of cancer-related mortality. Despite the widespread implementation of surveillance programs, more than half of the patients with HCC are diagnosed at late stages, when curative treatments (resection or liver transplantation) cannot be applied. For patients presenting with unresectable, non-transplantable HCC and a relatively preserved liver function, locoregional transarterial therapies are the main therapeutic options. Therefore, locoregional transarterial treatments play a key role in the management of HCC. The concept of catheter transarterial therapies is to selectively deliver anticancer treatments to liver tumors. This is possible due to the unique double irrigation of the liver and the predominantly arterial irrigation of liver tumors. Method: An exhaustive analysis of the literature, focused mainly on the last 25 years, has been carried out. Results: This review discusses the scientific evidence supporting the use of transarterial therapies for patients with HCC, including chemoembolization with conventional materials or drug-eluting beads, and internal radiation procedures such as the injection of radiation-loaded microspheres. Conclusion: Transarterial chemoembolization has been shown to improve the survival of those patients with unresectable HCC who have a preserved liver function and a low tumor burden. Recently developed devices and procedures, particularly drug-eluting beads and radioactive microspheres, may further improve the clinical outcome of patients receiving transarterial therapies. The combination with antiangiogenic agents is an appealing approach that should be explored.

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“…Regarding the use of HepaSphere, few data on HCC patients are available but a similar response rate of 51% at 6 months was reported in a multicenter study [60].…”

Section: Technical Considerationssupporting

confidence: 53%

Locoregional Transarterial Therapies for Hepatocellular Carcinoma: Transarterial Chemoembolization and Radioembolization

2013

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“…The convention for decades has been to deliver concentrated chemotherapeutic solutions in an ethiodized oil emulsion (Ethiodol; Savage Laboratories, Melville, NY), with or without particulate embolization, which results in a favorable pharmacokinetic profile (2 (11). After lyophilized cisplatin supplies were depleted, conventional TACE was performed by using only doxorubicin, up to 100 mg maximum.…”

Section: Implications For Patient Carementioning

confidence: 99%

Superselective Chemoembolization of HCC: Comparison of Short-term Safety and Efficacy between Drug-eluting LC Beads, QuadraSpheres, and Conventional Ethiodized Oil Emulsion

Duan¹,

Wang²,

Lam³

et al. 2016

Radiology

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q RSNA, 2015 Purpose:To study the comparative short-term safety and efficacy of transcatheter arterial chemoembolization (TACE) with drugeluting LC Beads loaded with doxorubicin (DEBDOX), doxorubicin-eluting QuadraSpheres (hqTACE), and conventional TACE using ethiodized oil for superselective C-arm computed tomography (CT)-guided treatment of hepatocellular carcinoma (HCC) after the onset of drug shortages. Materials and Methods:From March 2010 to March 2011, 166 patients with HCC were treated with 232 superselective TACE procedures using C-arm cone-beam CT at one institution. Patients underwent treatment depending on the availability of materials after the onset of drug shortages. Conventional TACE with doxorubicin, cisplatin, and Ethiodol was performed for 159 procedures, DEBDOX TACE was performed for 47, and hqTACE was performed for 26. Toxicity and objective response were compared at 3 months after treatment. Data were stratified for the high-risk population (Child-Pugh class B, performance status 1, bilobar disease, and/or postresection recurrence) and initial versus repeat treatment. Kruskal-Wallis H test, Mann-Whitney U test, and Fisher exact test were used to compare the groups, with Bonferroni correction where needed. Results:Whole liver response rates trended higher for conventional TACE (conventional TACE, 65.4%; DEBDOX, 63.8%; hqTACE, 53.8%) (P = .085). Only minor trends for differences in toxicity were observed between the three groups. Low-risk patients had higher whole liver (P = .001) and treated lesion (P = .007) response rates when treated with conventional TACE, but no significant differences were seen for DEBDOX and hqTACE. Treatment-naive patients also had higher whole liver (P = .012) and treated lesion (P = .056) response rates. No advantages for drug-eluting microspheres were found. Conclusion:Within statistical power limitations, overall toxicity and efficacy were equivalent in patients treated with LC Beads, QuadraSpheres, or ethiodized oil emulsions, including in high-risk patients, when performed superselectively with cone-beam C-arm CT guidance.q RSNA, 2015

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“…Therefore, doxorubicinloaded HepaSphere microspheres have less clinical validation although similar results to DC Bead have been reported. 48,49 Major studies with DC Bead are presented here.…”

Section: Drug-eluting Beads Transarterial Chemoembolizationmentioning

confidence: 99%

Systematic review of catheter-based intra-arterial therapies in hepatocellular carcinoma: state of the art and future directions

Durán¹,

Chapiro²,

Schernthaner³

et al. 2015

BJR

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Intra-arterial therapies (IATs) play a pivotal role in the management of patients with primary and secondary liver malignancies. The unique advantages of these treatments are their ability to selectively deliver a high dose of anticancer treatment while preserving healthy liver tissue. The proven efficacy of these catheter-based locoregional therapies in a highly systemic chemoresistant cancer such as hepatocellular carcinoma (HCC), along with the minimally invasive nature of these treatments, quickly yielded wide acceptance in the medical community and revolutionized the field of Interventional Oncology. In this article, we describe the clinical rationale and background of catheter-based IATs. We provide an overview of clinical achievements of these treatments alone and in combination with sorafenib in patients with HCC.

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Transarterial Chemoembolization for Hepatocellular Carcinoma with Drug-Eluting Microspheres: Preliminary Results from an Italian Multicentre Study

Cited by 117 publications

References 21 publications

Locoregional Transarterial Therapies for Hepatocellular Carcinoma: Transarterial Chemoembolization and Radioembolization

Locoregional Transarterial Therapies for Hepatocellular Carcinoma: Transarterial Chemoembolization and Radioembolization

Superselective Chemoembolization of HCC: Comparison of Short-term Safety and Efficacy between Drug-eluting LC Beads, QuadraSpheres, and Conventional Ethiodized Oil Emulsion

Systematic review of catheter-based intra-arterial therapies in hepatocellular carcinoma: state of the art and future directions

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