<p>Comparison of chemoembolization with CalliSpheres® microspheres and conventional chemoembolization in the treatment of hepatocellular carcinoma: a multicenter retrospective study</p>

Abstract

This study aimed to compare the efficacy and safety between transarterial chemoembolization (TACE) with CalliSpheres ® microspheres (CSM-TACE) and conventional TACE (cTACE) in patients with hepatocellular carcinoma (HCC). Patients and Methods: Three hundred and thirty-five HCC patients receiving CSM-TACE or cTACE were consecutively enrolled in this multi-center, retrospective cohort study, and then divided into CSM-TACE group and cTACE group accordingly. Complete response (CR), objective response (ORR) and disease control response (DCR) was assessed according to mRECIST criteria at 1 month (M1), 3 months(M3) and 6 months(M6) after treatment. Progression-free survival (PFS) and overall survival (OS) were assessed. Liver function indexes and adverse events (AEs) were also evaluated. Results: CR at M3 (P=0.020) and ORR at M1 (P<0.001), M3 (P<0.001) and M6 (P=0.017) after treatment were significantly higher in the CSM-TACE compared with cTACE group. DCRs, PFS (25.3 months vs 24.2 months, P=0.503) and OS (27.8 months vs 25.3 months, P=0.203) were similar between the two groups. CSM-TACE was independently correlated with higher ORR at M1 (P=0.002) and longer OS (P=0.023). Abnormal alkaline phosphatase (ALP) (P=0.049) was independently associated with lower ORR at M3, and history of alcohol intake (P=0.019) and largest nodule size ≥7 cm (P=0.015) independently correlated with lower ORR at M6 (P=0.015). Largest nodule size ≥7 cm (P=0.029) and abnormal albumin (ALB) (P=0.046) were independently associated with shorter PFS. Child-Pugh stage B/C (P=0.023), abnormal ALB (P=0.001), ALP (P=0.008) and alpha-fetoprotein (AFP) (P=0.005) were independently associated with shorter OS. Most liver function indexes and AEs were similar between the two groups (P>0.05), except that ALP (P=0.005), total bilirubin (P=0.031), pain during procedure (P=0.034) and occurrence of fever post(treatment (P=0.017) were significantly elevated in the CSM-TACE compared with cTACE group. Conclusion: CSM-TACE presents with a better treatment response and similar survival profile compared with cTACE in HCC patients.

Treatment Response, Survival, and Safety of Transarterial Chemoembolization With CalliSpheres® Microspheres Versus Conventional Transarterial Chemoembolization in Hepatocellular Carcinoma: A Meta-Analysis

“…In the present meta-analysis, we initially searched formally published studies to comprehensively compare the efficacy and safety of CSM-TACE with that of cTACE for treating HCC patients. A total of 16 studies and 1,454 patients with HCC were included, of whom 722 were treated with CSM-TACE and 732 were treated with cTACE (14)(15)(16)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). CR, ORR, DCR, PFS, OS, adverse events and liver function indexes were compared and analyzed.…”

“…Notably, only four included studies provided PFS and OS data. Three of them demonstrated a non-significant trend in favor of the CSM-TACE group, which was likely to be explained by the fact that the relative short median follow-up durations (range: 9.9-11.4 months) might reduce the statistic power (16,19,21). In contrast, another study revealed that CSM-TACE improved PFS and OS compared with cTACE in HCC patients with statistical significance (20).…”

Treatment efficacy and safety of drug-eluting beads transarterial chemoembolization versus conventional transarterial chemoembolization in hepatocellular carcinoma patients with arterioportal fistula

“…Treatment response was evaluated at 4–6 weeks after the DEB-TACE or cTACE referring to the modified Response Evaluation Criteria in Solid Tumors (mRECIST), 19 which was classified as complete response (CR), partial response (PR), stable disease (SD) and progressive disease (PD). Besides, the objective response rate (ORR) was calculated as the sum of CR and PR, and the disease control rate (DCR) was calculated as the sum of CR, PR, and SD.…”

Current updates in machine learning in the prediction of therapeutic outcome of hepatocellular carcinoma: what should we know?

“…Most HCC patients are typically diagnosed at intermediate or advanced stages when curative treatments cannot be applied [ 71 , 72 ]. According to the Barcelona Clinic Liver Cancer (BCLC) staging system [ 73 ] and several treatment guidelines [ 6 , 7 ], TACE is the gold standard for patients with intermediate-stage HCC.…”