Enhanced Therapeutic Efficacy of Combined Use of Sorafenib and Transcatheter Arterial Chemoembolization for Treatment of Advanced Hepatocellular Carcinoma

Zhou, Lin; Li, Jin; Ai, Ding-Lun; Fu, Junliang; Peng, Xiaoming; Linzhi, Zhang; Wang, Jingyan; Zhao, Yun; Yang, Bin; Yu, Qiang; Liu, Chunzi; Wang, Huaming

doi:10.1093/jjco/hyu068

Cited by 8 publications

(6 citation statements)

References 27 publications

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“…Thus, our study showed a decrease in OS associated to both parameters, which was independent of the assigned treatment. These data are in agreement with several retrospective studies that have reported this relationship [32,33] and with a recent study indicating that the presence of PVT is a predictive factor of poor survival in HCC [34].…”

Section: Discussionsupporting

confidence: 93%

Efficacy and Safety of the Combination of Pravastatin and Sorafenib for the Treatment of Advanced Hepatocellular Carcinoma (ESTAHEP Clinical Trial)

Riaño

Martin

Varela

et al. 2020

Cancers

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Pravastatin has demonstrated anti-tumor activity in preclinical and clinical studies. This multicentric randomized double-blind placebo-controlled phase II study (NCT01418729) investigated the efficacy and safety of sorafenib + pravastatin combination on the overall survival (OS) and time to progression (TTP) of patients with advanced hepatocellular carcinoma (aHCC). A total of 31 patients were randomized. Median OS did not differ between both groups (12.4 months for the sorafenib + pravastatin group vs. 11.6 months for the control group). Of note, however, the radiological TTP was higher in patients treated with sorafenib + pravastatin than in the control group (9.9 months vs. 3.2 months; p = 0.008). Considering all the study population, the presence of portal vein thrombosis (PVT) was associated with worse OS, being lower in patients with PVT compared to patients without PVT (6.3 months vs. 14.8 months; p = 0.026). Data also showed a decrease in OS in patients with vascular invasion (VI) compared to patients who did not present it (6.3 months vs. 14.8 months; p = 0.041). The group of patients without dermatological events (DE) showed lower OS (6.9 months vs. 14.5 months; p = 0.049). In conclusion, combination of sorafenib + pravastatin was safe and well-tolerated, prolonging the TTP of patients with aHCC but not improving the OS compared to sorafenib + placebo. The absence of PVT and VI and the development of DE are positive prognostic factors of sorafenib response.

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Section: Discussionsupporting

confidence: 93%

Efficacy and Safety of the Combination of Pravastatin and Sorafenib for the Treatment of Advanced Hepatocellular Carcinoma (ESTAHEP Clinical Trial)

Riaño

Martin

Varela

et al. 2020

Cancers

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“…The survival of these advanced HCC reported by these trials was 6–8 months in the sorafenib group, which might suggest that the benefits of sorafenib in HCC with MVI have been confirmed. However, several reports describe that the presence of MVI in HCC significantly decreases the survival of HCC patients treated with sorafenib monotherapy [26, 27]. Control of MVI is important to prolong survival in patients with advanced HCC because progression of MVI potentially leads to severe complications, such as liver failure, obstructive jaundice, or pulmonary embolism.…”

Section: Discussionmentioning

confidence: 99%

Dose and Location of Irradiation Determine Survival for Patients with Hepatocellular Carcinoma with Macrovascular Invasion in External Beam Radiation Therapy

et al. 2019

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Aim: Prognosis of hepatocellular carcinoma (HCC) with macrovascular invasion (MVI) is extremely poor. However, proper therapeutic strategies have not been established yet. The purpose of this study is to identify the effects of external beam radiation therapy (EBRT) for MVI of HCC. Methods: We have analyzed and evaluated 80 consecutive patients with HCC with MVI who underwent EBRT, and factors associated with enhanced survival in EBRT were evaluated by univariate and multivariate analysis. Results: The local response rate of radiotherapy for the irradiated MVI was 66.2%. The time to progression of the irradiated MVI was 5.8 months. Univariate and multivariate analyses showed that the higher irradiation dose (over 45 Gy) and the irradiation location (hepatic vein tumor thrombus – HVTT) were significant factors associated with survival benefits of EBRT. The response of EBRT for HVTT was significantly superior to that for portal vein or bile duct tumor thrombus. Conclusion: We conclude that a multidisciplinary therapeutic strategy based on EBRT should be proactively selected in the treatment of advanced HCC with MVI.

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“…MRI scan was performed by a GE Signa HDx 1.5T scanner or a GE Signa HDx 3.0T scanner (both from GE Healthcare, Milwaukee, WI, USA). The scans followed the protocol for standard contrast-enhanced abdominal CT or MRI examination as previously described 8 9 10 . The slice thickness was 1.25 mm, 2.5 mm, 5 mm, and 7 mm, respectively, for determining the effects of slice thickness on the recognition of VTSS and was 5 mm for both CT and MRI in other analysis.…”

Section: Methodsmentioning

confidence: 99%

The “Vessel through Strait” Sign is a Signature Radiological Sign for the Diagnosis of Left Hepatic Artery Variation

Rong

Wang²,

Wang

et al. 2016

Sci Rep

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An aberrant artery (AA) can frequently be observed coursing through the fissure for the ligamentum venosum (FLV) which was termed the “vessel through strait” sign (VTSS) by us. Fundamental data including the incidence, anatomical composition and clinical significance of VTSS and the AAs composing VTSS are still lacking. We sought to give a systematic demonstration on this issue in the present study. VTSS was respectively analyzed in 2,275 patients and was observed in 357 of them. Interestingly, 319 (89.4%) out of the 357 patients exhibiting VTSS were proved to have left hepatic artery variation (LHAV) (247 with replaced left hepatic artery, 64 with accessory left hepatic artery and 8 with variant common hepatic artery). We therefore hypothesized that VTSS could be a sign that strongly associated with LHAV and could be used for its diagnosis. In the following validating analysis, VTSS gained a sensitivity of 96.3% and a specificity of 98.3% for the diagnosis of LHAV in another bicenter cohort consisted of 1,329 patients. In conclusion, VTSS is a signature radiological sign of LHAV which could be used as an easy and specific method for the diagnosis of LHAV.

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Enhanced Therapeutic Efficacy of Combined Use of Sorafenib and Transcatheter Arterial Chemoembolization for Treatment of Advanced Hepatocellular Carcinoma

Cited by 8 publications

References 27 publications

Efficacy and Safety of the Combination of Pravastatin and Sorafenib for the Treatment of Advanced Hepatocellular Carcinoma (ESTAHEP Clinical Trial)

Efficacy and Safety of the Combination of Pravastatin and Sorafenib for the Treatment of Advanced Hepatocellular Carcinoma (ESTAHEP Clinical Trial)

Dose and Location of Irradiation Determine Survival for Patients with Hepatocellular Carcinoma with Macrovascular Invasion in External Beam Radiation Therapy

The “Vessel through Strait” Sign is a Signature Radiological Sign for the Diagnosis of Left Hepatic Artery Variation

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