Transarterial chemoembolization of colorectal cancer liver metastasis: improved tumor response by DSM-TACE versus conventional TACE, a prospective, randomized, single-center trial

Vogl, Thomas J.; Marko, Christian; Langenbach, M; Naguib, N; Filmann, Natalie; Hammerstingl, Renate; Gruber‐Rouh, Tatjana

doi:10.1007/s00330-020-07253-2

Cited by 17 publications

(16 citation statements)

References 32 publications

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“…Moreover, we observed that regorafenib plus DEB-TACE treatment prolonged PFS and OS compared with regorafenib monotherapy in CRLM patients who fail standard treatment regimens. Possible explanations for our data might be that: the persistent locoregional chemotherapy and embolization by DEB-TACE could ameliorate the progression of CRLM (Martin et al 2009;Vogl et al 2020), thus regorafenib plus DEB-TACE elongated the PFS of The adverse events of regorafenib or DEB-TACE in CRLM patients have been reported by previous studies. For instance, as to the adverse events related to regorafenib treatment, the CORRECT trial suggests that in the unresectable CRLM patients, the most commonly occurred adverse events are fatigue, hand-food-skin reaction and diarrhea, and the most commonly occurred grade ≥ 3 adverse events are hand-food-skin reaction and fatigue (Grothey et al 2013).…”

Section: Discussionmentioning

confidence: 56%

“…Another multicenter, single-arm study reveals that CRLM patients who receive DEB-TACE treatment after failure of standard treatment regimens present a median DFS of 247 days and a median OS of 343 days (Martin et al 2009). Moreover, a randomized, single-center trial suggests that DEB-TACE improves the OS (median value 16 vs. 13 months) of CRLM patients who fail first-and second-line treatment compared with conventional TACE (Vogl et al 2020). Therefore, it could be deduced that DEB-TACE might be a promising strategy for CRLM patients who fail standard treatment regimens, while its potential in combining with regorafenib as the third-line or above treatment for the unresectable CRLM patients is still unclear.…”

Section: Discussionmentioning

confidence: 99%

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Treatment efficacy and safety of regorafenib plus drug-eluting beads-transarterial chemoembolization versus regorafenib monotherapy in colorectal cancer liver metastasis patients who fail standard treatment regimens

Cao

Zheng

Luo

et al. 2021

J Cancer Res Clin Oncol

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Objective This study aimed to evaluate the efficacy and safety of regorafenib plus drug-eluting beads-transarterial chemoembolization (DEB-TACE) versus regorafenib monotherapy in colorectal cancer liver metastases (CRLM) patients who failed standard treatment regimens. Methods Totally, 76 eligible CRLM patients were analyzed, among which 42 patients received regorafenib monotherapy (as regorafenib group) and 34 patients received regorafenib plus DEB-TACE (as regorafenib plus DEB-TACE group). Results Objective response rate (35.3% versus 7.1%, P = 0.002) and disease control rate (76.5% versus 47.6%, P = 0.011) were both increased in regorafenib plus DEB-TACE group compared with regorafenib group; meanwhile, negative conversion rate of carcinoembryonic antigen (66.7% versus 28.6%, P = 0.008) after treatment was elevated in regorafenib plus DEB-TACE group compared with regorafenib group. Notably, progression-free survival (PFS) (median value: 7.6 versus 4.1 months, P < 0.001) and overall survival (OS) (median value: 15.7 versus 9.2 months, P < 0.001) were both higher in regorafenib plus DEB-TACE group compared with regorafenib group. Furthermore, liver function indexes (alanine transaminase, aspartate aminotransferase, and cholinesterase levels) after treatment were all similar between the two groups (all P > 0.05). In addition, the occurrences of upper abdominal distending pain (P < 0.001), nausea and vomiting (P = 0.002) and fever (P = 0.002) were higher in regorafenib plus DEB-TACE group compared with regorafenib group, while the majority of these adverse events were mild and tolerable. Conclusions Regorafenib plus DEB-TACE is superior to regorafenib monotherapy regarding treatment response, PFS and OS, while induces tolerable post-embolization syndrome in CRLM patients who fail standard treatment regimens.

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Section: Discussionmentioning

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Treatment efficacy and safety of regorafenib plus drug-eluting beads-transarterial chemoembolization versus regorafenib monotherapy in colorectal cancer liver metastasis patients who fail standard treatment regimens

Cao

Zheng

Luo

et al. 2021

J Cancer Res Clin Oncol

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“…Clinical trials on TACE for CLM are limited and restricted to palliative care/unresectable CLM only. Results of phase I and II studies showed that TACE can be safely applied in combination with chemotherapy, with promising tumor responses [49][50][51][52].…”

Section: Potentially Resectable or Initially Unresectable Liver Metastasesmentioning

confidence: 99%

Tailored Systemic Therapy for Colorectal Cancer Liver Metastases

Czauderna¹,

Luley

Bubnoff

et al. 2021

IJMS

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Liver metastases are the most common site of metastatic spread in colorectal cancer. Current treatment approaches involve effective systemic therapies in combination with surgical and/or interventional strategies. Multimodal strategies greatly improved clinical outcomes of patients with metastatic colorectal cancer over the last decades. Identification of predictive and prognostic biomarkers helped to comprehensively refine individual targeted treatment approaches and resulted in median overall survival rates of 30 months or longer. Current guidelines, thus, recommend treatment selection according to patients’ performance status, tumor localization and stage as well as the tumor’s molecular and genetic status. Here, we outline the latest developments in molecular decision-making for patients with upfront resectable, potentially or initially unresectable and non/never-resectable colorectal cancer liver metastases.

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“…Chemoembolization (TACE) combines the delivery of chemotherapeutic agents, such as mitomycin, doxorubicin, and cisplatin, emulsified in ethiodized oil resulting in particulate embolization of the distal hepatic arterioles or venules that trap the cytotoxic chemotherapy in the tumor microvasculature. Bland embolization following the delivery of TACE increases stasis and contact time of the chemotherapy in the tumor and reduces systemic exposure 71 . TACE can incorporate drug‐eluting beads in which chemotherapeutic agents such as doxorubicin or irinotecan (DEBIRI) are ionically bound to particles of various sizes resulting in a gradual prolonged release within the tumor and further reduces systemic exposure 72…”

Section: Summary Of Literature Reviewmentioning

confidence: 99%

American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

Hallemeier

Sharma

Anker

et al. 2023

Cancer

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The liver is a common site of cancer metastases. Systemic therapy is widely accepted as the standard treatment for liver metastases (LM), although select patients with liver oligometastases may be candidates for potentially curative liver resection. Recent data support the role of nonsurgical local therapies such as ablation, external beam radiotherapy, embolization, and hepatic artery infusion therapy for management of LM. Additionally, for patients with advanced, symptomatic LM, local therapies may provide palliative benefit. The American Radium Society gastrointestinal expert panel, including members representing radiation oncology, interventional radiology, surgical oncology, and medical oncology, performed a systemic review and developed Appropriate Use Criteria for the use of nonsurgical local therapies for LM. Preferred Reporting Items for Systematic reviews and Meta‐Analyses methodology was used. These studies were used to inform the expert panel, which then rated the appropriateness of various treatments in seven representative clinical scenarios through a well‐established consensus methodology (modified Delphi). A summary of recommendations is outlined to guide practitioners on the use of nonsurgical local therapies for patients with LM.

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Transarterial chemoembolization of colorectal cancer liver metastasis: improved tumor response by DSM-TACE versus conventional TACE, a prospective, randomized, single-center trial

Cited by 17 publications

References 32 publications

Treatment efficacy and safety of regorafenib plus drug-eluting beads-transarterial chemoembolization versus regorafenib monotherapy in colorectal cancer liver metastasis patients who fail standard treatment regimens

Treatment efficacy and safety of regorafenib plus drug-eluting beads-transarterial chemoembolization versus regorafenib monotherapy in colorectal cancer liver metastasis patients who fail standard treatment regimens

Tailored Systemic Therapy for Colorectal Cancer Liver Metastases

American Radium Society Appropriate Use Criteria for the use of liver‐directed therapies for nonsurgical management of liver metastases: Systematic review and guidelines

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