Chemoembolization of Hepatocellular Carcinoma: Patient Status at Presentation and Outcome over 15 Years at a Single Center

Brown, Daniel B.; Chapman, William C.; Cook, Richard J.; Kerr, Jason R; Gould, Jennifer E.; Pilgram, Thomas K.; Darcy, Michael

doi:10.2214/ajr.07.2879

Cited by 33 publications

(16 citation statements)

References 33 publications

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“…Studies demonstrated that for patients receiving TACE, advanced liver cirrhosis predicted an increased risk of mortality [7,22]. For CTP class B patients with intermediate stage HCC, the benefit of TACE on overall survival was not ascertained because the negative influence of hepatic decompensation on survival may offset the therapeutic effect [23].…”

Section: Discussionmentioning

confidence: 99%

Early identification of poor responders to transarterial chemoembolization for hepatocellular carcinoma

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Early identification of poor responders to transarterial chemoembolization for hepatocellular carcinoma

et al. 2011

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“…These studies used weight-based doxorubicin (1), 30 mg cisplatin (2), and weight-based doxorubicin and mitomycin-c (31), respectively. Numerous additional agents have been described, but a sizable portion of studies of chemoembolization of HCC have used the three aforementioned drugs alone or in some combination (7,8,(12)(13)(14)20,32). The present study demonstrates that, in patient groups with similar tumor stage and baseline liver function, patients who received DE required significantly more treatment sessions, experienced a lower response rate, and had a greater incidence of PD than those treated with chemoembolization with CDM or DEBs.…”

Section: Discussionmentioning

confidence: 63%

“…Because survival in patients with Child-Pugh class A disease is superior to that in patients with Child-Pugh class B or C disease (13,28), we evaluated the percentages of ChildPugh class A versus class B/C disease between groups with w 2 analysis. Differences in tumor stage between groups were determined by comparing the number of patients whose disease met Milan criteria (ie, stage T1/ T2) versus those whose disease was beyond this cutoff (ie, stage T3/T4) by using w 2 analysis (13).…”

Section: Discussionmentioning

confidence: 99%

“…Two commonly referenced prospective randomized trials (1,2) used different drugs: single-agent doxorubicin and cisplatin, respectively. Other commonly reported protocols for HCC describe the use of doxorubicin alone with ethiodized oil (1,11) or in combination with cisplatin and mitomycin-c (12)(13)(14). The development and increased use of drugeluting beads (DEBs) has created an additional variable to consider in treatment planning (15,16).…”

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confidence: 99%

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Single-center Comparison of Three Chemoembolization Regimens for Hepatocellular Carcinoma

Petruzzi

Frangos

Fenkel

et al. 2013

Journal of Vascular and Interventional Radiology

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“…Bland embolization aims tumor ischemia, depriving it of nutrients, resulting in tumor cell necrosis and apoptosis. Besides controlling tumor growth, it preserves healthy liver tissue due to the livers dual blood supply (Llovet 2003;Brown et al 2008). For TACE treatment, ischemia is an important part of therapy.…”

Section: Effects Of Locoregional Therapy On the Cellular Levelmentioning

confidence: 99%

Immunogenic Cell Death Markers in Liver Cancer

Kohles

Holdenrieder

2014

Biomarkers in Cancer

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Primary and secondary liver cancers are still a major medical and social problem due to the often late diagnosis and poor prognosis. Therefore meaningful biomarkers for better diagnosis, therapy stratification, and monitoring are highly needed. Beyond conventional clinical and tumor markers, immunogenic cell death (ICD) markers are promising new candidates. They comprise an inhomogeneous group of molecules that are released from apoptotic or necrotic cells. In blood, these danger-associated molecular patterns (DAMPs) such as the high-mobility group box 1 protein (HMGB1) are able to exert activating and suppressive effects on the immunity system and promote tumor growth and invasiveness.Here, we review the pathophysiology of primary and secondary liver cancer, the current therapeutic approaches, and the role of immunogenic cell death markers for the development and progression of cancer disease. Further, we report on their relevance as serum biomarkers for the diagnosis, estimation of prognosis, as well as the prediction and monitoring of response to cytotoxic therapy in cancer patients. Key Facts• Primary and secondary liver cancers are still a major medical and social problem because they often are diagnosed late and have a poor prognosis.• Meaningful biomarkers for better diagnosis, therapy stratification, and monitoring are highly needed.Beyond conventional clinical and tumor markers, immunogenic cell death (ICD) markers are promising new candidates.• ICD markers comprise an inhomogeneous group of molecules that are released from apoptotic or necrotic cells. In blood, these danger-associated molecular patterns (DAMPs) such as the high-mobility group box 1 protein (HMGB1), calreticulin, AFP, as well as nucleosomes are able to exert activating and suppressive effects on the immunity system and promote tumor growth and invasiveness.• In the case of HMGB1, these immunologic effects are mediated by diverse toll-like receptors and the receptor of advanced glycation end products (RAGE).• While circulating, HMGB1 and nucleosomes exert pro-immunogenic effects that may be enhanced when they are present in blood in form of HMGB1-nucleosome complexes; soluble RAGE and serum DNAse act as anti-immunogenic -by binding to HMGB1 as decoy receptor and by degrading nucleosomal DNA, respectively.• In cancer patients, serum levels of HMGB1 and nucleosomes are found to be elevated and further increased already 24 h after cytotoxic therapies are applied. The extent of HMGB1 and nucleosome increase correlates with poor patient prognosis and poor response to locoregional therapies in patients with liver malignancies and in patients with diverse cancers during systemic therapies. • In contrast, serum levels of sRAGE are decreased in cancer patients and further decline 24 h after therapeutic intervention. Low sRAGE levels correlate with poor prognosis and therapy response in diverse settings.• Inclusion of ICD markers into large, prospective anticancer therapy trials is needed to validate these promising findings and to define b...

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Chemoembolization of Hepatocellular Carcinoma: Patient Status at Presentation and Outcome over 15 Years at a Single Center

Abstract: Patients treated with hepatic arterial chemoembolization for HCC in Okuda score I and AJCC stage I or II have more durable survival than previously reported in a U.S. population.

Cited by 33 publications

References 33 publications

Early identification of poor responders to transarterial chemoembolization for hepatocellular carcinoma

Early identification of poor responders to transarterial chemoembolization for hepatocellular carcinoma

Single-center Comparison of Three Chemoembolization Regimens for Hepatocellular Carcinoma

Immunogenic Cell Death Markers in Liver Cancer

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