Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study

Fan, Wenzhe; Yuan, Guosheng; Fan, Huishuang; Li, Fuliang; Wu, Yanqin; Zhao, Yue; Wang, Yao; Wang, Yu; Xue, Mengzhou; Yang, Jing; Li, Jiaping

doi:10.1016/j.clinthera.2019.04.036

Cited by 38 publications

(36 citation statements)

References 43 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The patients who were included in this study were ( 1 ) patients who were diagnosed with HCC according to a pathologic examination or noninvasive criteria in accordance with the American Association for the study of Liver Disease guidelines ( 17 )/European Association for the Study of Liver, ( 2 ) patients with HCC in BCLC stage C, ( 3 ) patients with liver function graded at Child–Pugh A or B, ( 4 ) patients with Eastern Cooperative Oncology Group (ECOG) score of ≤2 points ( 18 ), ( 5 ) patients with platelet count ≥60 × 10 9 platelets per liter, neutrophil count >1.5 × 10 9 cells per liter, and hemoglobin >9 g/dl ( 19 ), and ( 6 ) patients with aspartate aminotransferase and alanine aminotransferase <200 U/L and total bilirubin ≤50 umol/l ( 19 ).…”

Section: Methodsmentioning

confidence: 99%

“…The patients who were excluded from the study were ( 1 ) patients with complete occlusion of the main portal vein ( 18 ), ( 2 ) patients with moderate or severe ascites, ( 3 ) patients who had previously undergone a treatment of oral sorafenib, liver resection, systemic chemotherapy, transarterial chemoinfusion, or TACE, ( 4 ) patients with serious comorbidities, such as severe dysfunction of the kidney, lung, or heart, and ( 5 ) patients who received other therapies during this study, such as iodine 125 seed implantation, radiofrequency ablation, external beam radiotherapy, or percutaneous ethanol injection.…”

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

et al. 2020

View full text Add to dashboard Cite

Background: Apatinib is a powerful inhibitor of vascular endothelial growth factor receptor-2. This study was aimed to investigate whether apatinib could improve the efficacy of transarterial chemoembolization (TACE) in patients with advanced hepatocellular carcinoma (HCC). Methods: Between June 2015 and September 2018, 357 patients with HCC at Barcelona Clinic Liver Cancer stage C who received the treatment of TACE combining with apatinib (TACE-apatinib) or TACE-alone were included. Propensity score matching (PSM) analysis was used to reduce the patient selection bias. Results: Ninety pairs of patients were chosen after the PSM analysis. The disease control rates of tumor and a-fetoprotein response in the TACE-apatinib group were significantly higher than that of the TACE-alone group before and after the PSM analysis (P < 0.05). Before the PSM analysis, the median time of tumor progression (TTP) and the overall survival (OS) in the TACE-apatinib group were significantly greater than those of the TACE-alone group (TTP: 9.0 months vs. 3.0 months, P < 0.001; OS: 14.0 months vs. 7.0 months, P < 0.001). After the PSM analysis, the median TTP and OS in the TACE-apatinib group was also significantly greater than that of the TACE-alone group (TTP: 7.0 months vs. 3.0 months, P < 0.001; OS: 13.0 months vs. 8.0 months, P < 0.001); the uni-and multivariate analysis revealed that TACE-apatinib was a protective factor for OS. Fourteen patients emerged with grade 3 apatinib-related adverse events. Conclusion: The efficacy of TACE-apatinib for patients with advanced HCC was inspiring, and the side effects of apatinib were tolerable.

show abstract

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Sample size of the study is calculated using log-rank test. The estimated OS is 11 months for the study arm and 7 months for the control arm (8,(19)(20)(21). The estimated study duration will be 3.5 years, including 2 years of recruitment, and 1.5 years of follow-up.…”

Section: Sample Sizementioning

confidence: 99%

Efficacy and Safety of SBRT Combined With Camrelizumab and Apatinib in HCC Patients With PVTT: Study Protocol of a Randomized Controlled Trial

Qin

et al. 2020

Front. Oncol.

View full text Add to dashboard Cite

Background: Hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) has poor prognosis. Sorafenib/lenvatinib is recommended as the first-line therapy in these patients currently, with unsatisfactory response and survival benefit reported. Radiotherapy (RT) is increasingly utilized in advanced HCC and is considered an alternative option for HCC patients with PVTT. Combined treatment of RT and locoregional treatments such as transarterial chemoembolization shows promising results. However, the efficacy and safety for combined treatment of RT and systemic therapy have not been reported and thus warrant further studies. This prospective clinic trial aims at evaluating the efficacy and safety of stereotactic body RT (SBRT) combined with camrelizumab and apatinib in HCC patients with PVTT. Methods: This multicenter, open-label, randomized controlled trial will enroll 264 HCC patients with PVTT who have not received systemic therapy previously. Stratification of patients will be based on the presence or absence of extrahepatic metastasis and level of AFP (AFP ≥ 400 or <400 ng/mL) and randomly assigned 1:1 to study and control groups. Patients in study group will receive SBRT (95% PTV 36-40 Gy/6-8 Gy), camrelizumab (200 mg every 3 weeks), and apatinib (250 mg every day), and patients in control group will receive camrelizumab (200 mg every 2 weeks) and apatinib (250 mg every day). Patients will be followed up for 1.5 to 3.5 years since the start of therapy. We will use overall survival as the primary endpoint and progression-free survival, objective response rate, disease control rate, adverse events, and quality of life as the secondary endpoints. Discussion: This study will be the first randomized controlled trial to assess the efficacy and safety of SBRT combined with camrelizumab and apatinib for HCC patients with PVTT. The results may help establish a new standard first-line therapy for these patients.

show abstract

“…After inclusion, 11 patients received 1 TACE session, 10 received 2 sessions, and 30 received 3 or more sessions. The median number of TACE treatments per patient was 3.6 ± 2.8 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14].…”

Section: Treatment Processmentioning

confidence: 99%

Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors

Liu

Kan

Zhang

et al. 2020

Preprint

View full text Add to dashboard Cite

Backgroud: To evaluate the overall survival (OS) after transarterial chemoembolization (TACE) combined with apatinib in patients with advanced hepatocellular carcinoma (HCC), and to identify the factors affecting patient survival. Methods: Fifty-one patients with HCC who received TACE combined with apatinib in our hospital from June 2015 to May 2017 were enrolled and followed up until May 2019. The OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Log-rank test and Cox regression model were used to determine the factors affecting the patients’ OS. Results: The median OS and PFS of the patients were 15 months and 10 months, respectively. The 1-, 2-, and 3-year survival rates were 62.7%, 23.5%, and 1.8%, respectively. Univariate survival analysis showed that patients with Child-Pugh A (P = 0.008), severe reduction rate of proper hepatic artery (P = 0.013), hand-foot syndrome (P = 0.006), secondary hypertension (P = 0.042), AFP< 400 ug/L (P = 0.076), and without ascites (P = 0.013) had a better OS. Multivariate analysis showed that hand-foot syndrome (P = 0.004), secondary hypertension (P = 0.034), and reduction rate of proper hepatic artery (P = 0.028) were independent predictors of better OS. Conclusions: TACE combined with apatinib is a promising treatment for advanced HCC. Hand-foot syndrome, secondary hypertension, and the reduction rate of proper hepatic artery were associated with a better OS.

show abstract

Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study

Cited by 38 publications

References 43 publications

Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Transarterial Chemoembolization Combined With Apatinib for Advanced Hepatocellular Carcinoma: A Propensity Score Matching Analysis

Efficacy and Safety of SBRT Combined With Camrelizumab and Apatinib in HCC Patients With PVTT: Study Protocol of a Randomized Controlled Trial

Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors

Contact Info

Product

Resources

About