Best radiological response to trans‐arterial chemoembolization for hepatocellular carcinoma does not imply better outcomes

Henry, Jon C.; Malhotra, Lavina; Khabiri, Hooman; G, Guy; Michaels, Anthony; Hanje, James; Azevedo, Marli S.P.; Bloomston, Mark; Schmidt, Carl

doi:10.1111/j.1477-2574.2012.00529.x

Cited by 11 publications

(8 citation statements)

References 21 publications

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“…Achievement of complete treatment response at an early time point was the most robust predictor for favorable outcomes . In contrast, there is another study suggesting that best radiological response to TACE does not imply better outcomes . Thus only complete radiological response with normalization of tumor markers after initial or repeated TACE can be a potential reason to delay LT in patients with small HCCs and compensated liver cirrhosis.…”

Section: Discussionmentioning

confidence: 97%

Prognostic effect of transarterial chemoembolization–induced complete pathological response in patients undergoing liver resection and transplantation for hepatocellular carcinoma

et al. 2017

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Transarterial chemoembolization (TACE)-induced complete pathological response (CPR) is known to improve postresection outcomes of hepatocellular carcinoma (HCC). We aimed to assess the prognostic effects of CPR after preoperative TACE for HCC in patients who underwent hepatic resection (HR) or liver transplantation (LT). The clinical outcomes of patients showing CPR after HR (n = 110) or LT (n = 233) were analyzed. The control groups comprised patients with minimal recurrence risk as naïve single HCC ≤ 2 cm for HR (n = 476), and 1 or 2 HCCs ≤ 2 cm for LT (n = 184). Among HR study patients, 1-, 3-, and 5-year tumor recurrence rates were 18.5%, 50.6%, and 58.7% respectively, which were higher than those of controls (P < 0.001). The 1-, 3-, and 5-year patient survival rates were 97.8%, 82.0%, and 69.1%, respectively, which were lower than those of controls (P < 0.001). Among LT study patients, 1-, 3-, and 5-year tumor recurrence rates were 4.1%, 7.9%, and 7.9%, respectively, which were higher than those of controls (P = 0.019). The 1-, 3-, and 5-year patient survival rates were 92.7%, 89.2%, and 86.9%, respectively, which were not different than those of controls (P = 0.11). LT recipients had lower recurrence and higher survival rates compared with HR patients (P < 0.001). The tumor recurrence site was mainly intrahepatic in HR patients. There was no difference between the incidences of extrahepatic recurrence in the HR study group and all-site recurrence in the LT study group (P = 0.61). We concluded that the prognostic effect of TACE-induced CPR for HCC patients appears to be limited to downstaging. LT recipients benefited more from CPR than HR patients. Liver Transplantation 23 781-790 2017 AASLD.

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Section: Discussionmentioning

confidence: 97%

Prognostic effect of transarterial chemoembolization–induced complete pathological response in patients undergoing liver resection and transplantation for hepatocellular carcinoma

et al. 2017

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“…94,124 That notwithstanding, objective response to TACE, radioembolization, and sorafenib has resulted in prolonged survival in randomized controlled trials and other studies, 109,114,118,[125][126][127][128][129][130][131][132] and may be associated with lower HCC recurrence after transplantation. 133,134 Lack of objective response after one or more therapies may portend poor survival, although this is controversial and is influenced by the type of therapy used 108,110,115,[135][136][137][138][139] and pattern of tumor progression (intrahepatic or extrahepatic). 140…”

Section: Value Of Assessment Of Responsementioning

confidence: 99%

Imaging Techniques for the Diagnosis of Hepatocellular Carcinoma and the Evaluation of Response to Treatment

2014

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Imaging plays a critical role in the diagnosis of hepatocellular carcinoma (HCC). In the USA, non-invasive imaging based diagnosis of HCC has largely replaced biopsy because of the high specificity and positive predictive value of imaging features for HCC. Because of the important role of imaging and the need to promote standardization of the management of HCC, several imaging-based algorithms for the diagnosis of HCC in at-risk patients have been developed.Imaging also plays a vital role in the assessment of HCC response to locoregional therapies (LRT) such as ablative and endovascular therapies. Standard imaging response criteria of solid tumors that rely solely on change in tumor size for determination of therapeutic success are not applicable to HCC undergoing LRT. Therefore, several systems have been developed over the years to objectively evaluate HCC response to LRT.In this review, we will describe major and ancillary imaging features of HCC, how these features are incorporated into the various imaging based algorithms, discuss the differences between algorithms, and address the emerging role of new imaging techniques and contrast agents in the diagnosis of HCC. We will also discuss the importance of assessment of HCC response to LRT, describe patterns of imaging response to the various therapies including newer volumetric and functional response measures, and examine and compare proposed response criteria of HCC to LRT.

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“…4 Because most patients have already progressed to the terminal period when they are diagnosed, they lose the opportunity for resection or transplantation. Conventional therapies, such as transcatheter arterial chemoembolization (TACE) and radiofrequency, have not had satisfying results 5,6 and concomitantly induced severe adverse effects due to non-specific cytotoxicity. Therefore, the need to identify a novel treatment approach is urgent.…”

Section: Introductionmentioning

confidence: 99%

Superparamagnetic iron oxide nanoparticles modified with polyethylenimine and galactose for siRNA targeted delivery in hepatocellular carcinoma therapy

Yang

Duan

Wang

et al. 2018

IJN

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IntroductionA safe and effective in vivo siRNA delivery system is a prerequisite for liver tumor treatment based on siRNA cancer therapeutics. Nanoparticles based on superparamagnetic iron oxide (SPIO) provide a promising delivery system. In this study, we aimed to explore a novel nanoparticle, which is composed of SPIO.Materials and methodsThe particles have a core of iron oxide that is modified by galactose (Gal) and polyethylenimine (PEI), which act as shells, providing targeted delivery of therapeutic siRNA to the liver cancer. Gal-PEI-SPIO nanoparticles were synthesized, and the characteristics of the Gal-PEI-SPIO encapsulated with siRNA were analyzed.ResultsThe particles remained nanoparticles and displayed negligible cytotoxicity when loaded with siRNA. In a serum stability assay, the Gal-PEI-SPIO nanoparticles could shield the siRNA from serum degradation and prolong the half-life of the siRNA in the system. Simultaneously, we found that the mixture could be efficiently taken up by Hepa1–6 cells in a flow cytometry assay. To study the anticancer effect, quantitative polymerase chain reaction and Western blotting were used to validate the silencing efficacy of the complexes in vitro. Subsequently, the nanoparticle mixtures were administered intravenously to tumor-bearing mice to explore the tissue distribution and the effect of the siRNA against cancer. We found that the nanoparticles could provide targeted siRNA delivery, accumulate easily in orthotopic tumors, enhance siRNA accumulation in the tumor tissues for 24 h and protect the siRNA from serum nuclease degradation in comparison with the control group. After these study procedures, the mice were sacrificed, and the tumors were removed to compare the tumor size and analyze the therapeutic effect on tumor growth. The tumor volume and the liver/body weight ratio were significantly reduced in the si-c-Met therapy groups. Additionally, the mRNA levels were also lower than those observed in the controls.ConclusionBased on these results, we concluded that Gal-PEI-SPIO represents a promising and efficient platform for siRNA delivery in tumor therapy.

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Best radiological response to trans‐arterial chemoembolization for hepatocellular carcinoma does not imply better outcomes

Cited by 11 publications

References 21 publications

Prognostic effect of transarterial chemoembolization–induced complete pathological response in patients undergoing liver resection and transplantation for hepatocellular carcinoma

Prognostic effect of transarterial chemoembolization–induced complete pathological response in patients undergoing liver resection and transplantation for hepatocellular carcinoma

Imaging Techniques for the Diagnosis of Hepatocellular Carcinoma and the Evaluation of Response to Treatment

Superparamagnetic iron oxide nanoparticles modified with polyethylenimine and galactose for siRNA targeted delivery in hepatocellular carcinoma therapy

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