Transarterial infusion chemotherapy with epirubicin in water-in-oil-in-water emulsion for recurrent hepatocellular carcinoma in the residual liver after hepatectomy

Ultraselective transcatheter infusion of epirubicin in water-in-oil-in-water emulsion for small hepatocellular carcinoma

“…The release of anticancer agents from lipiodol in a W/O/W emulsion is slow because the agent is contained within the lipiodol microdroplets, whereas in a conventional lipiodol emulsion it is contained in the external aqueous solution. Owing to these unique features of a W/O/W emulsion, we have already reported that transcatheter arterial infusion of a W/O/W emulsion is a good therapeutic option for patients with recurrent HCC following surgical resection and for those with multifocal HCC or liver dysfunction [5]. We also reported that the direct infusion of a W/O/W emulsion via the cystic artery is an effective and easy procedure for treating cases of HCC fed by the cystic artery with minimal risk of gallbladder damage, because when a W/ O/W emulsion is infused via this artery, washout occurs rapidly from the gallbladder, and the anticancer agent is released slowly from the lipiodol [6].…”

“…A water-in-oil-in-water (W/O/W) emulsion is a unique material that is advantageous because of its minimal embolic effect on peripheral arteries and a slow, sustained release of anticancer agent [1][2][3][4]. For that reason, transcatheter arterial infusion (TAI) of a W/O/W is particularly useful for patients with recurrent hepatocellular carcinoma (HCC) following surgical resection, as well as for those with multifocal lesions or liver dysfunction [5]. A W/O/W emulsion can also be safely infused via parasitic arteries, including the cystic artery, without the concern of damaging other organs [6].…”

Impact of Nanoparticles on Cancer Therapy

“…Furthermore, epirubicin, an anticancer drug, was encapsulated in water-in-oil-in-water emulsion containing glucose solution as the inner aqueous phase, lipiodol which consisted of polyglycerol esters of polycondensed fatty acids of castor oil, as the oily phase, and physiological saline with polyoxyethylene 60 stearate. The resulted formula revealed an effective treatment for patients with recurrent hepatocellular carcinoma after surgical resection [39]. The proper microemulsion delivery systems of some anticancer drugs have showed decreased cytotoxic effect and have improved the efficacy of the drug ( Figure 2 and Table 2).…”

Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma in Japan

“…Additional clinical trials have been performed in several faculties. Epirubicin alone or in combination with other chemotherapeutic agents such as mitomycin C or 5-FU has been used in HAIC for HCC in various Asian countries including Japan, with objective response rates ranging from 5% to 78% [22,23,24,25,26,27,28,29]. Reports of HAIC with anthracycline-based chemotherapeutic agents are listed in Table 1.…”