Alpha-Fetoprotein Response After Locoregional Therapy for Hepatocellular Carcinoma: Oncologic Marker of Radiologic Response, Progression, and Survival

Riaz, Ahsun; Ryu, Robert K.; Kulik, Laura; Mulcahy, Mary F.; Lewandowski, Robert J.; Minocha, Jeet; Ibrahim, Saad M.; Sato, Kent T.; Baker, Talia; Miller, Frank H.; Newman, Steven B.; Omary, Reed A.; Abécassis, Michaël; Benson, Al B.; Salem, Riad

doi:10.1200/jco.2009.23.1282

Cited by 203 publications

(173 citation statements)

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“…Notably, the measurement of AFP is a simple, quick, and cheap test. It is operator-independent [20] and routinely available in most parts of the world. This may have a particular value in countries where reliable radiological assessment is not readily accessible.…”

Section: Discussionmentioning

confidence: 99%

The Significance of Early Alpha-Fetoprotein Level Changes in Predicting Clinical and Survival Benefits in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib

et al. 2011

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Background. The role of serum alpha-fetoprotein (AFP) changes in predicting the treatment outcomes of advanced hepatocellular carcinoma (HCC) patients to sorafenib remains unknown.Methods. Serum AFP was collected prospectively at baseline and subsequent follow-up visits in parallel with clinical and survival outcomes. AFP response was defined as a relative drop of AFP >20% of the baseline level after 6 weeks of sorafenib. The relationship between AFP response and the treatment outcomes was first explored in patients who received sorafenib in a phase II study. Subsequently, an independent validation set of patients were obtained to validate the association of AFP response to clinical outcomes.Results. Included in the exploration and validation sets for analysis were 41 and 53 patients, respectively, with baseline AFP level >20 g/L. In the exploration

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Section: Discussionmentioning

confidence: 99%

The Significance of Early Alpha-Fetoprotein Level Changes in Predicting Clinical and Survival Benefits in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib

et al. 2011

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“…Selective internal radiation therapy (SIRT) with yttrium-90 ( 90 Y)-emitting microspheres is increasingly recognized as an effective therapy of both primary and secondary hepatic malignancies [1][2][3][4][5]. Increasing reports have shown this to be a useful treatment for unresectable hepatic metastases from colorectal carcinoma [6], neuroendocrine tumors [7], and primary hepatocellular carcinoma [3,8,9].…”

Section: Case Reportmentioning

confidence: 99%

“…Increasing reports have shown this to be a useful treatment for unresectable hepatic metastases from colorectal carcinoma [6], neuroendocrine tumors [7], and primary hepatocellular carcinoma [3,8,9]. A number of treatment-related complications have been described despite technical expertise and detailed pretreatment investigations to assess suitability.…”

Section: Case Reportmentioning

confidence: 99%

“…Recent reports have described their use as monotherapy for inop- erable hepatoma [3,5], as well as in combination with chemotherapy for unresectable hepatic metastases from colorectal cancer [1]. Although potentially an effective therapy, a number of complications can occur, even in the hands of an experienced operator.…”

Section: Sir-spheres Consist Of Microspheres Containingmentioning

confidence: 99%

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A Serious Complication of Selected Internal Radiation Therapy: Case Report and Literature Review

2010

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The use of selective internal radiation therapy (SIRT) with SIR-Spheres (Sirtex, Sydney, Australia) is increasingly recognized as a potential therapeutic modality of primary and secondary malignant liver tumors. A number of treatment-related complications have been described despite technical expertise and detailed pretreatment investigations to assess suitability. We describe a case of gastric ulceration from nontargeted deposition of SIR-spheres in the gastric mucosa with life-threatening consequences. This case highlights the need for careful screening and appropriate patient selection, and the need to recognize ulceration from SIRT as a potential complication of treatment. The characteristic endoscopic, radiologic, and histopathologic findings are illustrated and recommendations are reviewed with regard to the current literature. The Oncologist 2010;15:830 -835 CASE REPORTSelective internal radiation therapy (SIRT) with yttrium-90 ( 90 Y)-emitting microspheres is increasingly recognized as an effective therapy of both primary and secondary hepatic malignancies [1][2][3][4][5]. Increasing reports have shown this to be a useful treatment for unresectable hepatic metastases from colorectal carcinoma [6], neuroendocrine tumors [7], and primary hepatocellular carcinoma [3,8,9]. A number of treatment-related complications have been described despite technical expertise and detailed pretreatment investigations to assess suitability. We describe a case of gastric ulceration from aberrant deposition of SIR-Spheres (Sirtex, Sydney, Australia) in the gastric mucosa with lifethreatening consequences.The patient, a 63-year-old male with metastatic colorectal cancer, received SIRT 17 weeks earlier at another institution for recurrent, inoperable hepatic metastatic disease. The original diagnosis of rectosigmoid adenocarinoma was made 3 years earlier following an episode of infective endocarditis with Streptococcus viridians.

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“…Such dramatic effects have also been seen in other centers. The roles of biomarkers such as alpha-fetoprotein in response assessment following HCC continues to evolve [10].…”

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confidence: 99%

Yttrium-90 radioembolization in the management of liver tumors: expanding the global experience

Riaz

Salem

2009

Eur J Nucl Med Mol Imaging

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Alpha-Fetoprotein Response After Locoregional Therapy for Hepatocellular Carcinoma: Oncologic Marker of Radiologic Response, Progression, and Survival

Abstract: The data presented support the use of AFP response seen after locoregional therapy as an ancillary method of assessing tumor response and survival, as well as an early objective screening tool for progression by imaging.

Cited by 203 publications

References 30 publications

The Significance of Early Alpha-Fetoprotein Level Changes in Predicting Clinical and Survival Benefits in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib

The Significance of Early Alpha-Fetoprotein Level Changes in Predicting Clinical and Survival Benefits in Advanced Hepatocellular Carcinoma Patients Receiving Sorafenib

A Serious Complication of Selected Internal Radiation Therapy: Case Report and Literature Review

Yttrium-90 radioembolization in the management of liver tumors: expanding the global experience

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