scholarly journals Addition of Camrelizumab to Transarterial Chemoembolization in Hepatocellular Carcinoma With Untreatable Progression

2021 ◽  
Author(s):  
Yanqiao Ren ◽  
Ziyi Liu ◽  
Joyman Makamure ◽  
Xuefeng Kan ◽  
Songlin Song ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Events ◽  
Transarterial Chemoembolization ◽  
Objective Response ◽  
Multivariable Analysis ◽  
Progression Free Survival ◽  
Free Survival ◽  
Endothelial Proliferation ◽  
Tace Group ◽  
Tace Treatment

Abstract Purpose: To evaluate the efficacy and safety of camrelizumab addition to transarterial chemoembolization (TACE) in treatment of hepatocellular carcinoma (HCC) with TACE-related untreatable progression (UP).Methods: Patients with HCC who received addition of camrelizumab due to UP after initial TACE treatment were enrolled at our institution between May 2019 and January 2021. Patients were assessed for tumor response, progression-free survival (PFS), and adverse events. Risk factors for PFS were evaluated with logistic regression analysis.Results: A total of 41 patients were included. The objective response rate and disease control rate were 24.4% and 61.0% at 2-3 months, and 12.2% and 58.5% at 6 months, respectively. The median PFS of the patients were 6 months (95% CI: 3.8 months, 8.2 months). Of the 41 patients, 23 patients received camrelizumab combined with TACE (hereafter, camrelizumab-TACE), in whom 52 combined TACE procedures were performed, with a median of 2 procedures (range, 1-6) per patient. The remaining 18 patients received camrelizumab alone due to TACE contraindications. Multivariable analysis indicated that camrelizumab-TACE was an independent prognostic factor for PFS. Subgroup analysis showed a median PFS of 8 months in the camrelizumab-TACE group and 3 months in the camrelizumab monotherapy group (P<0.001). No treatment-related mortalities occurred. Seventeen patients (41.5%) developed at least one type of adverse events after treatment with camrelizumab, with reactive cutaneous capillary endothelial proliferation (n=14, 34.1%) being the most common adverse events.Conclusions: Addition of camrelizumab to TACE offered an effective and safe treatment for HCC with UP.

scholarly journals Transarterial Chemoembolization Combined with Radiofrequency Ablation in the Treatment of Stage B1 Intermediate Hepatocellular Carcinoma

2019 ◽  
Vol 2019 ◽  
pp. 1-7 ◽  
Author(s):  
Furong Liu ◽  
Minshan Chen ◽  
Jie Mei ◽  
Li Xu ◽  
Rongping Guo ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transarterial Chemoembolization ◽  
Progression Free Survival ◽  
Intermediate Stage ◽  
Multivariate Regression Analysis ◽  
Rank Test ◽  
Free Survival ◽  
Kaplan Meier ◽  
Tace Group

Background. Due to the heterogeneity of patients with Barcelona clinic liver cancer (BCLC) intermediate-stage hepatocellular carcinoma (HCC), Bolondi criteria were proposed and patients were divided into four substages. The purpose of this study was to compare the survival of substage B1 patients who were initially treated with a combination of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) (TACE-RFA) or TACE alone. Methods. 404 patients with stage B1 HCC were retrospectively analyzed from January 2005 to December 2012. 209 patients received TACE-RFA, and 195 received TACE alone as initial treatment. The overall survival (OS) and progression-free survival (PFS) rates were estimated by the Kaplan–Meier method and compared by the log-rank test. Results. 1-, 3-, and 5-year OS rates were 83.7%, 45.8%, and 24.8% in the TACE-RFA group and 80.7%, 26.4%, and 16.7% in the TACE group, respectively (P=0.003). The corresponding PFS rates were 71.8%, 26.6%, and 13.0% and 59.1%, 11.0%, and 2.2% in the TACE-RFA group and TACE group, respectively (P<0.001). Multivariate regression analysis indicated that tumor size (OS: hazard ratio (HR) = 0.683, P=0.001; PFS: HR = 0.761, P=0.013), along with treatment allocation (OS: HR = 0.701, P=0.003; PFS: HR = 0.620, P<0.001), was the independent prognostic factor for both OS and PFS. Conclusions. Combination TACE and RFA treatment yielded better survival than TACE alone for patients with stage B1 HCC according to the Bolondi criteria.

scholarly journals Efficacy of Regorafenib in Hepatocellular Carcinoma Patients: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 36 ◽  
Author(s):  
Antonio Facciorusso ◽  
Mohamed A. Abd El Aziz ◽  
Rodolfo Sacco
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Adverse Events ◽  
Therapeutic Option ◽  
Controlled Trial ◽  
Meta Analysis ◽  
Objective Response ◽  
Progression Free Survival ◽  
Sensitivity Analyses ◽  
Free Survival

Regorafenib showed promising results as a second-line agent after sorafenib failure in hepatocellular carcinoma patients. The aim of this meta-analysis was to evaluate the efficacy and safety of regorafenib in hepatocarcinoma patients. A computerized bibliographic search was performed on the main databases. The primary outcome was overall survival. Secondary outcomes were progression-free survival, tumor response, and the adverse events rate. Outcomes were pooled through a random-effects model and summary estimates were expressed in terms of median and 95% confidence interval or rates, as appropriate. One randomized-controlled trial and seven non-randomized studies with 809 patients were included. The great majority of recruited patients were in Child-Pugh A and ECOG 0 stage. Median overall survival was 11.08 months (9.46–12.71) and sensitivity analyses confirmed this finding, with a median survival ranging from 10.2 to 13.8 months. Duration of regorafenib therapy was 3.58 months, whereas median progression-free survival was 3.24 months (2.68–3.86). The pooled objective response rate was 10.1% (7.8–12.5%) while the disease control rate was 65.5% (61.3–69.7%) with no evidence of heterogeneity (I2 = 0%; Diarrhea, fatigue, and hand-foot skin reaction were the most frequent adverse events. The current meta-analysis shows that regorafenib represents a valuable and relatively safe therapeutic option in intermediate/advanced hepatocellular carcinomapatients who progress on sorafenib.

Comparison of treatment response, survival profiles as well as safety profiles between CalliSpheres® microspheres transarterial chemoembolization and conventional transarterial chemoembolization in huge hepatocellular carcinoma

2020 ◽  
Author(s):  
Xuhua Duan ◽  
Juanfang Liu ◽  
Xinwei Han ◽  
Jianzhuang Ren ◽  
Hao Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Function ◽  
Treatment Response ◽  
Transarterial Chemoembolization ◽  
Protective Factor ◽  
Objective Response ◽  
Progression Free Survival ◽  
Cox's Regression ◽  
Tace Group ◽  
Huge Hepatocellular Carcinoma

Abstract Background: This study aimed to compare treatment response, survival and safety profiles between drug-eluting beads transarterial chemoembolization (DEB-TACE) with CalliSpheres® microspheres (CSM) and conventional TACE (cTACE) in huge hepatocellular carcinoma (HCC) patients.Methods: 71 patients with huge HCC underwent DEB-TACE or cTACE were consecutively enrolled. Treatment response was assessed at first month (M1), third month (M3) and sixth month (M6) after TACE therapy; progression free survival (PFS) and overall survival (OS) were evaluated; liver function indexes were recorded before TACE operation (M0), at first week (W1), M1 and M6 after TACE therapy; adverse events which occurred after TACE operation were recorded. Results: DEB-TACE presented with higher objective response rate (ORR) and disease control rate (DCR) compared to cTACE. Regarding survival profiles, the short-term mortality rate was lower, and PFS as well as OS were longer in DEB-TACE group compared with cTACE group. Multivariate Cox’s regression further illustrated that DEB-TACE vs cTACE was an independent protective factor for PFS and OS. As for safety profiles, patients’ liver function injury was reduced in DEB-TACE group compared with cTACE group. The incidence of fever was lower and CINV were less severe in DEB-TACE group compared with cTACE group, while no difference in occurrence of liver abscess, increase of ascites or moderate pain between two groups was observed. Conclusion: DEB-TACE with CSM presents with better treatment response, survival profiles as well as safety profiles compared to cTACE in treatment for huge HCC patients.

scholarly journals Transarterial Chemoembolization Combined with Iodine 125 Seeds Versus Transarterial Chemoembolization Combined with Radiofrequency Ablation in the Treatment of Early and Intermediate Hepatocellular Carcinoma

2020 ◽  
Author(s):  
chen lei ◽  
Xuefeng Kan ◽  
Tao Sun ◽  
Yanqiao Ren ◽  
Yanyan Cao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Transarterial Chemoembolization ◽  
Objective Response ◽  
Progression Free Survival ◽  
Free Survival ◽  
Risk Of Death ◽  
Significant Difference ◽  
Pugh Class ◽  
Iodine 125

Abstract Background To compare the efficacy of the combination of transarterial chemoembolization (TACE) and iodine 125 seeds implantation (TACE-Iodine 125) with the combination of TACE and radiofrequency ablation (RFA) in the treatment of patients with early and intermediate hepatocellular carcinoma (HCC). Methods The study included 134 patients diagnosed with early and intermediate HCC from January 1, 2014, to May 31, 2018. Among them, 47 patients were treated with TACE-Iodine 125, and 87 with TACE-RFA and the efficacy of both treatments was analyzed. To reduced selective bias, propensity score matching (PSM) was used to compare the outcomes of the treatments. Results In the absence of PSM, the median overall survival (OS) and progression-free survival (PFS) of the TACE-RFA group were slightly longer than those of the TACE-Iodine 125 group (OS: 42 months vs. 37 months; PFS: 18 months vs. 15 months). However, there was no significant difference in median OS, PFS, and the objective response rate (ORR) between the two groups (P>0.05). After adjusted for age, gender, liver resection, Child-Pugh class, Barcelona Clinic Liver Cancer (BCLC) stage and Alpha-fetoprotein (AFP), TACE-Iodine 125 treatment was not associated with a significant increasing in risk of death (HR: 0.725; 95%CI: 0.423,1.241, P=0.241) and recurrence (HR: 1.008; 95%CI: 0.666,1.526, P=0.969). After PSM, 47 patient pairs were generated, and there was no significant difference in median OS and PFS between the two groups. Conclusions The combination of TACE and iodine 125 seeds implantation may represent an effective treatment for patients with early and intermediate HCC.

scholarly journals Superselective Transarterial Chemoembolization for Unresectable or “Ablation Unsuitable” Hepatocellular Carcinoma in the Caudate Lobe: A Real World, Single-Center Retrospective Study

2021 ◽  
Vol 11 ◽  
Author(s):  
Liangliang Yan ◽  
Yanqiao Ren ◽  
Kun Qian ◽  
Xuefeng Kan ◽  
Hongsen Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Response Rate ◽  
Medical Center ◽  
Objective Response ◽  
Multivariable Analysis ◽  
Major Complication ◽  
Progression Free Survival ◽  
Caudate Lobe ◽  
Complication Rates

ObjectivesTo analyze the clinical outcomes of Transarterial chemoembolization (TACE) for unresectable or “ablation unsuitable” hepatocellular carcinoma (HCC) in the caudate lobe (CL) found at initial presentation in clinical practice.MethodsFifty-eight patients with HCC-CL undergoing conventional TACE from January 2015 to January 2020 were enrolled in our medical center. Overall survival (OS), progression-free survival (PFS), tumor response rate and major complication rates were analyzed. Multivariate analyses for potential clinical and radiologic factors were performed by using the Cox proportional hazard model.ResultsThe median OS was 23 months (95%CI: 18.1-27.9), and the median PFS was 11 months (95%CI: 7.4-14.6). The 1-, 3-, and 5-years OS rates were 66.5%, 31.9% and 15.7%, respectively. The 0.5, 1-, and 3-years PFS rates were 60.3%, 44.5% and 6.3%, respectively. Objective response rate was 53.4% and disease control rate was 79.3%. The most serious complication was bile duct injury, with an incidence of 3.4%. Multivariable analysis revealed that total bilirubin, Barcelona Clinic Liver Cancer stage, nonselective chemoembolization and TACE session were four significant factors associated with OS.ConclusionsSuperselective TACE treatment might be associated with better survival benefits in unresectable or “ablation unsuitable” HCC in the CL without macroscopic vascular invasion (MVI) and adequate liver function, compared with the non-selective TACE group, and should be considered as an important reliable therapy for surgeons and interventional radiologists.

scholarly journals Regorafenib Combined With Sintilimab Versus Regorafenib as Second-line Treatment for Advanced Hepatocellular Carcinoma

2021 ◽  
Author(s):  
Jingjun Huang ◽  
Yongjian Guo ◽  
Wensou Huang ◽  
Zining Xu ◽  
Liteng Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Adverse Events ◽  
Objective Response ◽  
Progression Free Survival ◽  
Advanced Hepatocellular Carcinoma ◽  
Line Treatment ◽  
Second Line ◽  
Free Survival ◽  
Advanced Hcc ◽  
Grade 3

Abstract Purpose: To evaluate the safety and efficacy of regorafenib combined with immune checkpoint inhibitor sintilimab (rego-sintilimab) as second-line treatment for advanced hepatocellular carcinoma (HCC) patients who failed prior sorafenib or lenvatinib.Methods: This retrospective study evaluated consecutive patients with advanced HCC who received rego-sintilimab (rego-sintilimab group) or regorafenib alone (regorafenib group) as second-line treatment from January 2019 to December 2020. Adverse events, objective response rate (ORR), progression-free survival (PFS), and overall survival (OS) were compared between the two groups. Results: Eighty-three patients were included: 48 received rego-sintilimab and 35 received regorafenib. Rego-sintilimab group had higher ORR (33.3% vs 14.3%, P =.049), longer PFS (median, 5.1 vs 3.0 months; P =.001), and better OS (median, 13.3 vs 9.1 months; P =.001) than regorafenib group. Regorafenib alone, Child-Pugh B, and neutrophil-to-lymphocyte ratio (NLR) >3.5 were independent prognostic factors for poor OS in uni- and multi-variable analyses. Subgroup analyses showed that, in patients with Child-Pugh A (16.4 vs 11.5 months; P =.005), Child-Pugh B (8.8 vs 6.4 months; P =.032), or NLR ≤3.5 (16.3 vs 11.5 months; P =.012), rego-sintilimab group had significantly better median OS than regorafenib group, whereas median OS was not significantly different between the two groups in patients with NLR >3.5 (8.4 vs 7.0 months; P =.288). The incidences of grade 3/4 adverse events were similar between the two groups (39.4% vs 34.1%; P =.445).Conclusion: Rego-sintilimab was tolerable and led to better OS than regorafenib as second-line treatment for advanced HCC patients, especially in those with NLR ≤3.5.

scholarly journals Efficacy and Safety of DEB-TACE for Patients With Hepatocellular Carcinoma With the Largest Tumor Diameter ≥7 cm

2020 ◽  
Author(s):  
Wei Chen ◽  
Bei Lu ◽  
Mengzeng Zhang ◽  
Zhenguo Hou
Keyword(s):  
Hepatocellular Carcinoma ◽  
Overall Survival ◽  
Transarterial Chemoembolization ◽  
Cox Regression ◽  
Objective Response ◽  
Progression Free Survival ◽  
Tumor Diameter ◽  
Tace Group ◽  
Huge Hepatocellular Carcinoma

Abstract Objective: To explore the effectiveness and safety of DEB-TACE in patients with primary huge hepatocellular carcinoma. Methods: From January 2017 to January 2019, 87 patients with huge unresectable HCC were retrospectively analyzed. 48 cases received drug-elutted beads for transarterial chemoembolization (DEB-TACE group), and 39 cases received conventional transarterial chemoembolization (c-TACE group). The tumor treatment response, overall survival (OS), progression-free survival (PFS), the incidence of adverse events (AEs) were compared between the two groups and the factors influencing OS were analyzed. Results: The median follow-up was 295 days (ranges 78 to 603 days). There was no statistical difference in baseline characteristics and follow-up treatment between the two groups. The objective response rate(ORR) of DEB-TACE group was higher than that of c-TACE group within 3 months after treatment. The change was similar in the incidence of AEs between the two groups; DEB-TACE group showed longer PFS and OS than c-TACE group. Cox-regression multivariate analysis showed that DEB-TACE was an important factor affecting the overall survival. Conclusion: DEB-TACE prolonged the survival time of patients with huge unresectable HCC and could be a better choice than c-TACE without increasing the incidence of AEs.

Transarterial chemoembolization with or without microwave ablation in the treatment of intermediate (BCLC B) hepatocellular carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e15635-e15635 ◽  
Author(s):  
Feng Shi ◽  
Shanshan Lian ◽  
Peihong Wu ◽  
Lujun Shen
Keyword(s):  
Hepatocellular Carcinoma ◽  
Transarterial Chemoembolization ◽  
Microwave Ablation ◽  
Progression Free Survival ◽  
Intermediate Stage ◽  
Tumor Diameter ◽  
First Line ◽  
Free Survival ◽  
Tace Group ◽  
Complete Tumor

e15635 Background: Transarterial chemoembolization (TACE) is currently the first-line treatment for patients with intermediate (BCLC stage B) hepatocellular carcinoma (HCC). However, the prognosis of patients with intermediate HCC remains unsatisfactory, because TACE was limited by its lack of ability to achieve complete tumor necrosis. In this study, we retrospectively compare the outcome of TACE with or without microwave ablation (MWA) in the treatment of intermediate HCC. Methods: Included in this study were 140 patients with intermediate stage HCC who underwent initial TACE and were potentially amendable for MWA (the sum of the size of the largest tumor in centimeters and the number of tumors should be no more than nine; and a total tumor diameter ≤11 cm) between January 2005 and February 2015. 75 patients were treated with following MWA (TACE-MWA), and the remaining 65 patients were treated with TACE alone. Cumulative overall survival (OS) and progression-free survival (PFS) rates were compared. Results: The respective 1-, 3-, and 5-year OS rates were 80%, 30%, and 20% in the TACE group; and 96%, 69%, and 48% in the TACE-MWA group (Fig. 2). The OS was statistically significantly better in the TACE-MWA group compared with the TACE group (P < 0.001). The respective 1-, 3-, and 5-year PFS rates were 53%, 13%, and 0% in the TACE group; and 59%, 27%, and 17% in the TACE-MWA group (Fig. 3B). PFS rates between the two groups did not differ significantly (P = 0.069). Conclusions: MWA following initial TACE prolongs OS and PFS of patients with potentially amendable intermediate HCC.

scholarly journals Sequential transarterial chemoembolization and early radiofrequency ablation improves clinical outcomes for early-intermediate hepatocellular carcinoma in a 10-year single-center comparative study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Liangliang Yan ◽  
Yanqiao Ren ◽  
Kun Qian ◽  
Xuefeng Kan ◽  
Hongsen Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiofrequency Ablation ◽  
Combination Therapy ◽  
Clinical Outcomes ◽  
Transarterial Chemoembolization ◽  
Response Rate ◽  
Multivariable Analysis ◽  
Complication Rates ◽  
Tace Treatment

Abstract Background Transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) are effective treatment methods for unresectable hepatocellular carcinoma (HCC). However, there is still a lack of clinical research on whether early sequential RFA, compared with late combination therapy, can improve the long-term efficacy of initial TACE treatment. Methods This retrospective study investigated a cohort of patients who underwent combination therapy using TACE and RFA (TACE followed by RFA) from January 2010 to January 2020 at our medical centre. A total of 96 patients underwent TACE combined with early RFA (usually during the first hospitalization), which was called TACE + eRFA. Thirty-four patients received 1–2 palliative TACE treatments first and then underwent TACE treatment combined with late RFA (TACE + lRFA). All patients continued to receive palliative TACE treatments after intrahepatic lesion progression until reaching intolerance. The overall survival (OS) rate, time to tumour progression (TTP), tumour response rate and major complication rates were compared between the two groups. Results There were significant differences in the median OS (46 months vs 33 months; P = 0.013), median TTP (28 months vs 14 months; P < 0.00), objective response rate (ORR) (89.6% vs 61.8%, P = 0.000) and disease control rate (DCR) (94.8% vs 73.5% P = 0.002) between the two groups. Multivariable analysis revealed that the Barcelona Clinic Liver Cancer stage was an independent risk factor for OS. Meanwhile, multivariable analysis revealed that TACE + eRFA was associated with an enhanced TTP. Conclusion Early sequential RFA treatment in patients with early-intermediate HCC can improve local tumour control and clinical outcomes while reducing the frequency of TACE treatment. In clinical practice, in HCC patients initially treated with TACE, it is recommended to combine RFA as soon as possible to obtain long-term survival.

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