Clinical Practice Guidelines for Hepatic Arterial Infusion Chemotherapy with a Port System Proposed by the Japanese Society of Interventional Radiology and Japanese Society of Implantable Port Assisted Treatment

Ueshima, Kazuomi; Komemushi, Atsushi; Aramaki, Takeshi; Iwamoto, Hideki; Obi, Shuntaro; Sato, Yozo; Tanaka, Toshihiro; Matsueda, Kiyoshi; Moriguchi, Michihisa; Saito, Hiroya; Sone, Miyuki; Yamagami, Takuji; Inaba, Yoshitaka; Kudo, Masatoshi

doi:10.1159/000524893

Cited by 14 publications

(17 citation statements)

References 102 publications

(206 reference statements)

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“…Implantable Port Assisted Treatment proposed clinical practice guidelines for HAIC with a port system, which will support more widespread application of HAIC [31]. HAIC could be a promising therapeutic modality for locally advanced HCC, such as MVI including PVTT.…”

Section: Iwamoto H Et Al Haic In the Era Of Chemo-diversitymentioning

confidence: 99%

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Iwamoto¹,

Shimose²,

Shirono³

et al. 2023

Clin Mol Hepatol

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Recently, treatments for unresectable hepatocellular carcinoma (HCC) have undergone remarkable development. Various systemic chemotherapy drugs have been approved and are recommended by clinical guidelines worldwide. Although systemic treatments are effective and contribute to prolonged patient survival, their effects are unsatisfactory for some specific tumor conditions, such as macrovascular invasion. Hepatic arterial infusion chemotherapy (HAIC) is a traditional treatment for advanced HCC. As yet, there is no worldwide consensus recommending HAIC because no high-quality clinical trials have demonstrated its survival benefit. However, clinical evidence is gradually accumulating that shows its survival benefit, and it is recognized as an effective locoregional treatment for advanced HCC. Several HAIC regimens have been reported, including cisplatin monotherapy, cisplatin plus 5-fluorouracil (low-dose FP), lipiodol-suspended FP, and an oxaliplatin-based regimen. We have entered an era of chemo-diversity in the treatment of advanced HCC. This review aimed to clarify the relevance of HAIC in the era of chemo-diversity. We propose a multidisciplinary therapeutic strategy combining locoregional HAIC treatment with sequential drug therapy, with the aim of becoming cancer-free through conversion therapy.

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Section: Iwamoto H Et Al Haic In the Era Of Chemo-diversitymentioning

confidence: 99%

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Iwamoto¹,

Shimose²,

Shirono³

et al. 2023

Clin Mol Hepatol

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“…The percutaneously implanted port-catheter system, mostly used in Japan, China, and Europe, is cost-effective for patients who need multiple cycles of HAIC or continuous administration of time-dependent chemotherapeutic agents, such as 5-fluorouracil. 36 – 40 This technique can achieve whole-liver perfusion during HAIC while also being simpler, safer, and faster than a surgically implanted pump. Nevertheless, the implantation of a percutaneously implanted port-catheter system should be performed at a specialized interventional radiology center, and the port-catheter system should be regularly maintained with heparin to prevent thrombosis in the system.…”

Section: Haic Techniquesmentioning

confidence: 99%

“…(1) As a trans-arterial whole liver local treatment, HAIC is generally recommended for patients with locally advanced HCC with large tumors, a high tumor burden, or diffuse tumors, especially with portal vein/hepatic vein/biliary tract tumor thrombosis, in case that the tumor is confined within the liver or exhibits only limited extrahepatic metastasis. 40 , 46 …”

Section: Indications For Haicmentioning

confidence: 99%

Techniques and status of hepatic arterial infusion chemotherapy for primary hepatobiliary cancers

Zheng,

Wang

2024

Ther Adv Med Oncol

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Primary hepatobiliary cancers (PHCs), which mainly include hepatocellular carcinoma (HCC) and biliary tract cancers (BTCs), are mostly diagnosed in the advanced stage and are not candidates for curative surgery or ablation, resulting in a dismal prognosis. Targeted therapies with or without programmed death receptor 1 (PD-1)/PD-L1 inhibitors have been incorporated into first-line treatments for advanced HCC. Systemic chemotherapy is still the mainstay treatment for advanced BTCs, and combining it with PD-1/PD-L1 inhibitors has resulted in prolonged patient survival. Intra-arterial therapies, including trans-arterial chemoembolization, selective internal radiation therapy, and hepatic arterial infusion chemotherapy (HAIC), have been explored and used for advanced hepatobiliary cancers for many years with positive results, particularly when combined with systemic treatments. Recently, an increasing number of phase II/III trials have demonstrated the efficacy and safety of HAIC for the treatment of advanced HCC with portal vein tumor thrombosis and/or a large tumor burden, for the neoadjuvant and adjuvant treatment of HCC with high-risk factors, and for treating advanced intrahepatic and perihilar cholangiocarcinoma. However, the techniques and regimens used for HAIC are diverse and differ greatly between various regions and centers worldwide. This review focuses on these diverse techniques and regimens, as well as the updated evidence on HAIC regarding the treatment of PHCs.

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“…HAIC was the standard therapy for advanced HCC in Japan (33,34). However, the role of HAIC has been reconsidered due to recent progress in systemic therapies (35).…”

Section: B-3 Haicmentioning

confidence: 99%

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Japanese perspective

Koga¹,

Iwamoto²,

Suzuki³

et al. 2023

Clin Mol Hepatol

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Striking advances in systemic therapy for unresectable advanced hepatocellular carcinoma (HCC) have improved the average prognosis of patients with HCC. As a result, the guidelines for the treatment of HCC have changed significantly. However, various issues have emerged in clinical practice. First, there is no established biomarker that can predict response to systemic therapy. Second, there is no established treatment regimen after primary systemic therapy, including combined immunotherapy. Third, there is no established treatment regimen for intermediate-stage HCC. These points make the current guidelines ambiguous. In this review, we present the Japanese guidelines for the diagnosis and treatment of HCC based on the latest evidence; introduce various efforts mainly in Japanese real-life practice to update these guidelines; and present our perspectives on future guidelines.

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Clinical Practice Guidelines for Hepatic Arterial Infusion Chemotherapy with a Port System Proposed by the Japanese Society of Interventional Radiology and Japanese Society of Implantable Port Assisted Treatment

Cited by 14 publications

References 102 publications

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Techniques and status of hepatic arterial infusion chemotherapy for primary hepatobiliary cancers

Clinical practice guidelines and real-life practice in hepatocellular carcinoma: A Japanese perspective

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