A Randomized Phase II Study of Drug-Eluting Beads versus Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma

Malenstein, Hannah van; Maleux, Geert; Vandecaveye, Vincent; Heye, Sam; Laleman, Wim; Pelt, Jos van; Vaninbroukx, Johan; Nevens, Frederik; Verslype, Chris

doi:10.1159/000329602

Cited by 120 publications

(99 citation statements)

References 37 publications

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“…None of those trials demonstrated a difference in survival, but patients treated with drug-eluting bead tace consistently experienced fewer adverse events [69][70][71][72] .…”

Section: Summary Of Evidencementioning

confidence: 99%

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

Bossé

Ahmad

et al. 2016

Current Oncology

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The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016 was held in Montreal, Quebec, 5-7 February. Experts in radiation oncology, medical oncology, surgical oncology, and infectious diseases involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics:■ Follow-up and survivorship of patients with resected colorectal cancer ■ Indications for liver metastasectomy ■ Treatment of oligometastases by stereotactic body radiation therapy ■ Treatment of borderline resectable and unresectable pancreatic cancer ■ Transarterial chemoembolization in hepatocellular carcinoma ■ Infectious complications of antineoplastic agents

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“…None of those trials demonstrated a difference in survival, but patients treated with drug-eluting bead tace consistently experienced fewer adverse events [69][70][71][72] .…”

Section: Summary Of Evidencementioning

confidence: 99%

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

Bossé

Ahmad

et al. 2016

Current Oncology

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“…Complications mainly include pleural effusion, gastric ulcers, esophageal variceal bleeding, liver failure, cholangitis, and abscess formation (22,23). Aminotransferase levels also rise but they are generally believed to return to normal after a few days.…”

Section: Complications Of Drug-loaded Microspheresmentioning

confidence: 99%

Advances in endovascular therapy to treat primary hepatocellular carcinoma

Guo

Liu

et al. 2015

DD&T

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“…Surprisingly often, however, this crucial information on the formulation is not fully described and summarized in clinical reports [12,53,[83][84][85][86]. When it is reported, ratios of aqueous:LIP appear to be in the range of 4:1 to 1:3.33, but are mostly 1:1 [87][88][89][90][91][92]. As suggested by the in vitro data (Figure 4), only aqueous:LIP ratios of 1:2-4 will result in w/o emulsions with sustained in vitro release of DOX.…”

Section: In Vivo Behavior Of Lipdox In the Hepatobiliary Systemmentioning

confidence: 99%

Treatment of Intermediate Stage Hepatocellular Carcinoma: A Review of Intrahepatic Doxorubicin Drug-Delivery Systems

Dubbelboer

Lilienberg

Ahnfelt

et al. 2014

Therapeutic Delivery

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The biopharmaceutical properties of doxorubicin delivered via two drug-delivery systems (DDSs) for the palliative treatment of unresectable hepatocellular carcinoma were reviewed with relation to the associated liver and tumor (patho)physiology. These two DDSs, doxorubicin emulsified with Lipiodol ® and doxorubicin loaded into DC Bead ® are different regarding tumor delivery, release rate, local bioavailability, if and how they can be given repeatedly, biodegradability, length of embolization and safety profile. There have been few direct head-to-head comparisons of these DDSs, and in-depth investigations into their in vitro and in vivo performance is warranted.The global incidence of liver cancer is increasing and this type of cancer has a poor prognosis and is ranked as the third most common lethal cancer form [1,2]. The recommended treatment for hepatocellular carcinoma (HCC), a primary liver cancer, is dependent on the stage of the disease [3]. For unresectable, intermediate stage HCC, transarterial chemoembolization (TACE) is recommended. TACE involves the delivery of the cytostatic agent(s) in a drug-delivery system (DDS) to the tumor via the hepatic artery (HA) [3]. In contrast to normal liver tissue, which has a dual blood supply from the HA and the portal vein [4], HCC is typically mainly vascularized by the HA. Local drug administration by the TACE DDS is expected to increase the specificity of the tumor response while reducing the frequency of side effects and morbidity compared with systemic dosed treatments [4]. Embolization, caused by the DDS, obstructs the blood flow in the tumor, induces hypoxia, and results in increased drug concentrations and prolonged residence times in the tumortarget area [4]. Patients with untreated HCC that has not invaded the portal vein or spread extrahepatically have an expected median survival of approximately 16 months. With current palliative TACE strategies, the expected median survival is prolonged by approximately 4 months [3].To date, several DDSs delivering various chemotherapeutic drug(s) and pharmaceutical excipients have been developed and clinically evaluated for TACE therapy [5]. A review of these options of TACE DDSs is warranted in that it would form the basis for optimizing tumor-targeted therapy for HCC treatment, and subsequent development of novel, tumor-targeted DDSs and dosing strategies. Two common DDSs used for TACE therapy for intermediate stage HCC involve cytostatic agents emulsified in Lipiodol ® (LIP) or loaded into drugeluting beads. LIP is an iodized poppy seed oil derivative visible on x-ray, and after administration, the contrast is preferentially retained in tumor tissue [6,7]. The combination of the cytostatic agent emulsified in LIP can be administered with or without additional embolizing materials, generating complete or partial embolization of the targeted tumor-feeding vessel(s) [3,8]. DC Bead ® (DCB) is one of several commercially available drug-eluting embolizing bead systems [9]. Positively charged chemotherapeutic drugs can be ...

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A Randomized Phase II Study of Drug-Eluting Beads versus Transarterial Chemoembolization for Unresectable Hepatocellular Carcinoma

Cited by 120 publications

References 37 publications

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

Eastern Canadian Gastrointestinal Cancer Consensus Conference 2016

Advances in endovascular therapy to treat primary hepatocellular carcinoma

Treatment of Intermediate Stage Hepatocellular Carcinoma: A Review of Intrahepatic Doxorubicin Drug-Delivery Systems

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