Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma

Baek, Yang Hyun; Kim, Kyoung‐Tae; Lee, Sung Wook; Jeong, Jin Sook; Park, Byeong Ho; Nam, Kyung Jin; Cho, Jin Han; Kim, Young Hoon; Roh, Young Hoon; Lee, Hyung Sik; Choi, Young Min; Han, Sang Young

doi:10.3748/wjg.v18.i26.3426

Cited by 18 publications

(19 citation statements)

References 34 publications

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“…Though not a significant multivariate variable, a ChildPugh score of 5 was an important factor predicting good outcome (median OS of Child class A5, A6 and B were 16, 7 and 3 mo, respectively). This result is consistent with the results of HAIC studies showing that the ChildPugh score was an independent survival factor [30,36] . Thus, HAIC using ECF could be indicated in selected patients with tumor volumes < 400 cm 3 , good hepatic reserve function, and low PIVKA-Ⅱ levels.…”

Section: Discussionsupporting

confidence: 82%

Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Song

Bae²,

Song³

et al. 2013

WJG

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AIM:To evaluate the prognostic factors and efficacy of hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis. METHODS:Fifty hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT) were treated using hepatic arterial infusion chemotherapy (HAIC) via a subcutaneously implanted port. The epirubicin-cisplatin-5-fluorouracil (ECF) chemotherapeutic regimen consisted of 35 mg/m 2 epirubicin on day 1, 60 mg/m 2 cisplatin for 2 h on day 2, and 500 mg/m 2 5-fluorouracil for 5 h on days 1-3. The treatments were repeated every 3 or 4 wk. RESULTS:Three (6%) of the 50 patients achieved a complete response (CR), 13 (26%) showed partial responses (PR), and 22 (44%) had stable disease (SD).The median survival and time to progression were 7 and 2 mo, respectively. After 2 cycles of HAIC, CR was achieved in 1 patient (2%), PR in 10 patients (20%) and SD in 26 patients (52%). Significant pre-treatment prognostic factors were a tumor volume of < 400 cm 3 (P = 0.01) and normal levels of protein induced by vitamin K absence or antagonist (PIVKA)-Ⅱ (P = 0.022). After 2 cycles of treatment, disease control (CR + PR + SD) (P = 0.001), PVTT response (P = 0.003) and α-fetoprotein reduction of over 50% (P = 0.02) were independent factors for survival. Objective response (CR + PR), disease control, PVTT response, and combination therapy during the HAIC were also significant prognostic factors. Adverse events were tolerable and successfully managed. CONCLUSION: HAIC may be an effective treatment modality for advanced HCC with PVTT in patients with tumors < 400 cm 3 and good prognostic factors.© 2013 Baishideng. All rights reserved. Key words: Hepatocellular carcinoma; Hepatic arterial infusion chemotherapy; Portal vein tumor thrombosisCore tip: The aim of this study was to investigate the prognostic factors of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma patients with portal vein tumor thrombosis. The primary findings of this study were as follows: (1) The median survival and time to progression were 7 and 2 mo, respectively; (2) A tumor volume of < 400 cm 3 and protein induced by vitamin K absence or antagonist-Ⅱ were independent pre-treatment prognostic factors; (3) Disease control and ≥ 50% tumor marker reduction were significant prognostic factors after the second cycle of hepatic arterial infusion chemotherapy (HAIC); and (4) Objective tumor response, disease control and portal vein tumor thrombosis response were independent post-treatment prognostic factors at the end of the HAIC. ORIGINAL ARTICLE

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Section: Discussionsupporting

confidence: 82%

Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Song

Bae²,

Song³

et al. 2013

WJG

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“…Current treatment options for HCC, including surgical approaches, locoregional ablative techniques and interventional ablation treatments, could increase the 5-year-survival rate to 75% (vs. 30% prior to these treatments), however, <20% of HCC patients qualify for these treatments (2). Although the promising 5-year-survival rate of HCC cases has been increased due to advances in surgical techniques, nutritional support and perioperative management, long-term survival after surgical resection remains low due to the high rate of recurrence and metastasis (3,4). Novel evidence-based therapies for HCC are urgently required.…”

Section: Introductionmentioning

confidence: 99%

Targeting the Ras/Raf/MEK/ERK pathway in hepatocellular carcinoma

2017

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Abstract. Although the biological basis of hepatocellular carcinoma (HCC) remains unclear, effective treatments and improvement of the survival rate remain worthwhile research goals. Abnormal protein signaling pathways contributing to uncontrolled cell proliferation, differentiation, survival and apoptosis are biomarkers of the carcinogenic process. Certain mutated components or overexpression of the rat sarcoma virus (Ras)/rapidly accelerated fibrosarcoma (Raf)/mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) signaling pathway are increasingly being studied in HCC carcinogenesis. The present review addresses the effect of the Ras/Raf/MEK/ERK signaling pathway on the pathogenesis of HCC, and provides an update on the preclinical and clinical development of various inhibitors targeting this core signaling pathway, which include various Ras inhibitors, Raf inhibitors and MEK inhibitors for HCC.

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“…Despite the fact that different cytotoxic agents have been used across the spectrum of different primary tumors, 5-fluoro-2'-deoxyuridine (floxuridine) has been traditionally regarded as an optimal agent for HAI. However, the experience with floxuridine in HCC is more limited 9 . In addition to fluoropyrimidine (mostly 5-fluorouracil) monotherapy 29 , the combination of 5-fluorouracil and cisplatin has been the most commonly used HAI regimen in HCC (ref.…”

Section: Discussionmentioning

confidence: 99%

“…While the experience with HAI in the West is limited 21,22 , many studies on HAI have been reported from East Asia, especially Japan. A number of prospective trials and retrospective series have reported the results of HAI in Asian patients with hepatocellular carcinoma 8,9 . The efficacy and tolerance of HAI in Asian HCC patients has also been reviewed recently [10][11][12][13]29 .…”

Section: Discussionmentioning

confidence: 99%

“…While chemoembolization, another liver-directed procedure targeting the vasculature, is a standard method in the management of patients with inoperable HCC based on the results of prospective trials indicating survival benefit 7 , the utilization of HAI in this setting is less frequent. Numerous studies on HAI in HCC have been reported from East Asia, especially from Japan [8][9][10][11][12][13][14][15][16][17][18][19][20] , but the experience with this approach in the Caucasian population of Western countries is very limited 21,22 . The use of HAI is currently not recommended in therapeutic guidelines, but this approach has been used in the past.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic arterial infusion in hepatocellular carcinoma: a single center experience

Melichar¹,

Dvořák²,

Ferko³

et al. 2015

BIOMED PAP

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Aim. The aim of the present study was to evaluate a single center experience with hepatic arterial infusion (HAI) in patients with hepatocellular carcinoma. Methods. A retrospective analysis of 20 patients treated for hepatocellular carcinoma between 1994 and 2007. Results. Most patients were treated with an HAI of doxorubicin and cisplatin combined with 5-fluorouracil and folinic acid. The response was not evaluable in the majority of patients, predominantly because of associated surgical procedure or because only one cycle of HAI was administered. The median progression-free survival was 7.7 months. The median survival of all patients was 12.2 months (5-year survival 5%). Serious adverse events were observed in 5 patients, and one patient died of liver failure in association with the administration of HAI. Conclusion. The data show the limited efficacy of HAI in patients with hepatocellular carcinoma.

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Efficacy of hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma

Abstract: The present study demonstrates that intra-arterial FUDR chemotherapy is a safe and effective treatment for advanced HCC that is recalcitrant to other therapeutic modalities, even in patients with advanced cirrhosis.

Cited by 18 publications

References 34 publications

Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Hepatic arterial infusion chemotherapy in hepatocellular carcinoma with portal vein tumor thrombosis

Targeting the Ras/Raf/MEK/ERK pathway in hepatocellular carcinoma

Hepatic arterial infusion in hepatocellular carcinoma: a single center experience

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