Hepatic Arterial Infusion Chemotherapy Using Oxaliplatin Plus 5-Fluorouracil Versus Transarterial Chemoembolization/Embolization for the Treatment of Advanced Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis

Hu, Jungang; Bao, Quan; Cao, Guang; Zhu, Xu; Yang, Renjie; Ji, Xinqiang; Xu, Liang; Zheng, Kanglian; Li, Wei-Liang; Xing, Baocai; Wang, Xiaodong

doi:10.1007/s00270-019-02406-3

Cited by 45 publications

(26 citation statements)

References 37 publications

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“…The findings from a study analyzing patients with HCC and PVTT who underwent HAIC showed that the median OS (7.1 months) and PFS (3.3 months) were shorter than those obtained in this study [32]. A previous study [18] of our center investigated the effects of HAIC versus TACE/TAE administered to HCC with major PVTT and showed that the median OS in the HAIC group and TACE/-TAE group were 20.8 months and 4.0 months, respectively. The OS of HAIC alone was longer than this study.…”

Section: Discussioncontrasting

confidence: 59%

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Combination Therapy of Chemoembolization and Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Compared with Chemoembolization Alone: A Propensity Score-Matched Analysis

Liu

Gao

Zhu

et al. 2021

BioMed Research International

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Background. Survival of patients with portal vein tumor thrombosis (PVTT) is extremely poor; transarterial chemoembolization (TACE) is a treatment for patients with HCC and PVTT. Some studies showed that hepatic arterial infusion chemotherapy (HAIC) might improve the survival of HCC with PVTT. There were few researches of combining TACE with HAIC for patients with HCC and PVTT. Aim. This study was aimed at comparing overall survival (OS) and progression-free survival (PFS) following treatment with conventional transarterial chemoembolization plus hepatic arterial infusion chemotherapy (cTACE-HAIC) or conventional transarterial chemoembolization (cTACE) alone in patients with hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT). Methods. From January 2011 to December 2016, 155 patients with HCC and PVTT who received cTACE-HAIC (cTACE-HAIC group) ( n = 86 ) or cTACE alone (cTACE group) ( n = 69 ) were retrospectively evaluated. Propensity score matching (PSM) reduced the confounding bias and yielded 60 matched patient pairs. The tumors’ responses were evaluated using the modified response evaluation criteria in solid tumors (mRECIST). OS and PFS of groups were compared using the Kaplan-Meier method, log-rank test, and Cox proportional hazard regression models. Results. The median follow-up duration was 93 months (range: 1–93 months). The cTACE-HAIC group’s OS (9.0 months) and PFS (6.0 months) were significantly longer than the cTACE group’s OS (5.0 months) and PFS (2.0 months) ( p = 0.018 and p = 0.045 , respectively) in the matched cohort. Multivariate analyses showed that cTACE-HAIC was independently associated with OS (hazard ratio (HR) 0.602, p = 0.010 ) and PFS (HR 0.66, p = 0.038 ). The matched groups did not differ regarding grade 3 or 4 adverse events. Conclusion. cTACE-HAIC was superior to cTACE alone regarding OS and PFS in patients with HCC and PVTT. Treatment-associated toxicities were generally well tolerated.

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Section: Discussioncontrasting

confidence: 59%

“…HAIC can transport anticancer agents to tumors at high local concentrations and reduce dissemination to areas unaffected by cancer. In addition, many studies' findings [15][16][17][18] have demonstrated that HAIC effectively treats patients with HCC and PVTT and that it significantly prolongs a patient's survival.…”

Section: Introductionmentioning

confidence: 99%

Combination Therapy of Chemoembolization and Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Compared with Chemoembolization Alone: A Propensity Score-Matched Analysis

Liu

Gao

Zhu

et al. 2021

BioMed Research International

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“…In the included studies for the Chinese patients, most HAIC regimens adopted HAIC of oxaliplatin, leucovorin, and fluorouracil. On the other hand, Japan and Korea generally adopted HAIC treatment based on cisplatin for the advanced HCC patients [20, 22, 24, 26, 31]. We also realized that the average age of patients in China was lower than that in Japan and Korea.…”

Section: Discussionmentioning

confidence: 91%

The Role of Hepatic Arterial Infusion Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Hong-ya

et al. 2021

Chemotherapy

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Background: The main aim of this study was to investigate comprehensively the clinical effect of hepatic arterial infusion chemotherapy (HAIC) on patients suffering from hepatocellular carcinoma (HCC). Methods: The following electronic databases were searched for eligible articles published from inception to July 2020: PubMed, Web of Science, Embase, and Cochrane Library. The main final indicators were overall survival (OS), disease-free survival (DFS), and progression-free survival (PFS). Results: A total of 26 studies entailing 4,506 cases were included for a meta-analysis. The results showed that HAIC could improve advanced HCC patients’ OS (HR, 0.49; 95% CI: 0.37–0.61) and PFS (HR, 0.52; 95% CI: 0.36–0.68). Remarkably, compared with Japan (HR, 0.58) and Korea (HR, 0.54), for the unresectable HCC patients, the HAIC group achieved higher efficacy on OS than the control group in China (HR, 0.24). The resectable HCC patients, who received HAIC adjuvant chemotherapy, exhibited favorable prognosis for OS (HR, 0.58; 95% CI: 0.27–0.88) and DFS (HR, 0.49; 95% CI: 0.31–0.68). Conclusion: HAIC improved long-term survival for both resectable and unresectable HCC patients in comparison with other therapies. However, the clinical effect of HAIC needs to be ascertained by large-scale well-designed studies.

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“…However, HAIC is not a standard treatment recommended within current guidelines due to the relative sparsity of gold-standard clinical trials conducted to date [10]. Recent clinical trials have provided some evidence supporting the efficacy of HAIC in the treatment of HCC, and the clinical evidence in regard to HAIC has gradually been increasing [11,12]. Herein, we report on the efficacy of an HAIC regimen, "New-FP" (i.e., fine-powder cisplatin [DDP-H, Nippon Kayaku Co. Ltd., Tokyo, Japan] suspended in lipiodol and 5-fluorouracil), in the treatment of advanced HCC.…”

Section: Introductionmentioning

confidence: 99%

Hepatic Arterial Infusion Chemotherapy New-FP for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombus

Iwamoto

Niizeki

Nagamatsu

et al. 2022

Preprint

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Background/Purpose: Although macrovascular invasion (MVI), particularly major portal vein tumor thrombus (PVTT), is a critical tumor condition in hepatocellular carcinoma (HCC), determining the optimal treatment is an unmet medical need. We aimed to compare the efficacy of hepatic arterial infusion chemotherapy (HAIC) regimens New-FP (fine-powder cisplatin/ lipiodol suspension and 5-fluorouracil) and sorafenib for MVI-HCC and major PVTT-HCC in patients with preserved liver function. Methods: We retrospectively analyzed 1,709 consecutively presenting patients with HCC who were initially treated with New-FP or sorafenib (March 2009 to June 2019). Overall survival and prognostic factors were assessed in both groups after propensity score matching (n=198 each). Subgroup analyses were conducted in four groups: cohort 1 (no MVI or extrahepatic spread [EHS]), cohort 2 (MVI only), cohort 3 (EHS only), and cohort 4 (MVI and EHS). Cohort 5 evaluated major PVTT (including EHS). Results: The New-FP group had a longer median survival time (MST) than the sorafenib group (New-FP, 18 months; sorafenib, nine months; p<0.0001). New-FP demonstrated a statistically longer MST compared with sorafenib in cohorts 2 and 4. In cohort 5, the MST of the New-FP group was 16 months, while that of sorafenib was six months (p<0.0001). For major PVTT-HCC, the objective response rate for New-FP was 73.0%. The MST of patients who achieved a complete response with New-FP (16.6%) was 59 months. Conclusion: New-FP showed significant efficacy for MVI-HCC, including major PVTT-HCC. Even in the era of systemic treatment, HAIC using New-FP is a promising modality for patients with advanced HCC.

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Hepatic Arterial Infusion Chemotherapy Using Oxaliplatin Plus 5-Fluorouracil Versus Transarterial Chemoembolization/Embolization for the Treatment of Advanced Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombosis

Cited by 45 publications

References 37 publications

Combination Therapy of Chemoembolization and Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Compared with Chemoembolization Alone: A Propensity Score-Matched Analysis

Combination Therapy of Chemoembolization and Hepatic Arterial Infusion Chemotherapy in Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis Compared with Chemoembolization Alone: A Propensity Score-Matched Analysis

The Role of Hepatic Arterial Infusion Chemotherapy in the Treatment of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Hepatic Arterial Infusion Chemotherapy New-FP for Hepatocellular Carcinoma with Major Portal Vein Tumor Thrombus

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