Polyethylene Glycol Epirubicin-Loaded Transcatheter Arterial Chemoembolization Procedures Utilizing a Combined Approach with 100 and 200 μm Microspheres: A Promising Alternative to Current Standards

Lucatelli, Pierleone; Argirò, Renato; Rubeis, Gianluca De; Rocco, Bianca; Corradini, Stefano Ginanni; Corona, Mario; Nardis, Piergiorgio; Saba, Luca; Mennini, Gianluca; Fiorentino, Francesco; Corsi, Alessandro; Catalano, Carlo; Bezzi, Mario

doi:10.1016/j.jvir.2018.10.026

Cited by 14 publications

(14 citation statements)

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“…Treatment with LifePearl™ was well tolerated in the authors' study and agreed with the findings of several previous studies, which demonstrated good procedure safety and AEs of mild intensity (e.g., postembolic syndrome and fever) [6,[17][18][19][20][21][22][23][24][25]. Liver toxicity with TACE with doxorubicin-loaded microspheres was usually reflected by increases in AST, GGT, ALT and bilirubin levels [6,23,24].…”

Section: Discussionsupporting

confidence: 86%

“…LifePearl™ microspheres are approved for loading with doxorubicin, idarubicin and epirubicin and have good tolerability and efficacy in HCC treatment [6,[17][18][19][20][21][22][23][24]. Doxorubicin is the most frequently used drug for TACE in HCC treatment [17,23,24] and is used in the current study, which is aimed at assessing the tolerability, treatment efficacy and safety of LifePearl™ in HCC patients.…”

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confidence: 99%

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Unresectable hepatocellular carcinoma treatment with doxorubicin-eluting polyethylene glycol microspheres: a single-center experience

et al. 2021

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Background: Transarterial chemoembolization (TACE) is indicated for unresectable hepatocellular carcinoma. Methods: This was a retrospective study of 50 hepatocellular carcinoma patients treated with TACE using doxorubicin-loaded LifePearl™ to investigate the safety and efficacy of TACE. Results: There was no 30-day mortality, and limited adverse events were reported. At best tumor response, complete response and disease control were 58% and 94%, respectively, with a median of 4.5 months of follow-up. Median overall survival was 33.8 months. Patients with Barcelona Clinic Liver Cancer stage 0 and stage A at best tumor response showed a higher complete response rate (83%) than patients with Barcelona Clinic Liver Cancer stage B (complete response: 50%; p = 0.0414). Conclusion: Doxorubicin-loaded LifePearl™ TACE might be an effective treatment, with a good safety profile, for patients with early/intermediate-stage hepatocellular carcinoma. Further prospective data, especially with a small cohort of selected patients, are required to confirm these results.

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Section: Discussionsupporting

confidence: 86%

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confidence: 99%

Unresectable hepatocellular carcinoma treatment with doxorubicin-eluting polyethylene glycol microspheres: a single-center experience

et al. 2021

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“…Despite this, literature evidence on oncological response of b-TACE over standard non occluded TACE is controversial [3][4][5][6] In order to evaluate the adjunctive value of b-TACE we retrospectively evaluated the results of patients treated in our institution with b-TACE and compared them with an historical cohort treated with non-occluded DEM-TACE. b-TACE and DEM-TACE were performed by the same team under dual phase CBCT guidance i.e..: better tumor/feeders visualization) 15 , with rigorous standardization of the embolization procedure (sequential embolization with 100 and 200 microns particles 12 ), being the only technical variable the balloon micro-catheter employment. B-TACE had a trend for higher TTR after an initial complete response vs DEM-TACE at 1-year, con rmed also by the Coxregression analyses weighted for the presence of micro-balloon catheter and tumors' diameter.…”

Section: Discussionmentioning

confidence: 99%

“…This is a case-control, retrospective, single center study.The data of 159 consecutive patients with 248 HCC tumors managed in our tertiary center for liver cancer treatment between January 2015 and March-2019 were reviewed. All TACE was indications were discussed at the multidisciplinary tumor board comprising a transplant surgeon, an interventional radiologist, body radiologist and a hepatologist, according to the Quality Improvement Guidelines for Hepatic Transarterial Chemoembolization of the CIRSE [12].…”

Section: Methodsmentioning

confidence: 99%

“…The embolization protocol used, for both B-TACE and DEM-TACE, was highly standardized since January-2015. The protocol consisted, as previously reported 12 , in a sequential embolization, starting with 100 ± 25 µm PEG microspheres, immediately followed by a second embolization with 200 ± 50 µm, PEG microspheres when needed.…”

Section: Dem-tace and B-tace Techniquementioning

confidence: 99%

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Balloon Occluded TACE (B-TACE) vs DEM-TACE for HCC. A Single Center Retrospective Case Control Study.

Lucatelli

Rubeis

Rocco

et al. 2020

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Background To compare oncological results and safety profile of balloon micro-catheter trans-arterial chemoembolization (b-TACE) and drug-eluting-microsphere (DEM-TACE) in patients with hepatocellular-carcinoma (HCC).Methods This is a case-control, retrospective, single-center study. Between January-2015/March-2019, 149 patients (131 males [87.9%]) with 226 HCC were treated, 22 patients (35 HCC; 19 [86.4%] males) with b-TACE and 127 with DEM-TACE (191 HCC, 112 [88.2%] males). Embolization protocol was standardized (sequential 100±25 and 200±25 μm microspheres). Results were evaluated by modified-response-evaluation-criteria-in-solid-tumor [mRECIST] at 1, 3-6 and 9-12 months and time to recurrence after complete response [TTR] at 1 years. Cox’s regression weighted with tumor dimensions was performed. Adverse events (AEs) were recorded.Results mRECIST oncological response at all time points (1, 3-6 and 9-12 months) for both treatments were similar, with the exception of Objective response rate at 9-12months. Objective response at 1 and 3-6 months between b-TACE vs DEM-TACE [23/35 (65.7%) vs 119/191 (62.3%), 21/29 (72.4%) vs 78/136 (57.4%) (p>0.05), respectively]. On the contrary, at 9-12 months, it was significantly higher in b-TACE subgroup than DEM-TACE (15/19 [78.9%] vs 48/89 [53.9%], p=0.05). TTR for complete response at 1 year had a better trend for b-TACE vs DEM-TACE (278.0 days [196.0-342.0] vs 219.0 days [161.0-238.0], OR 0.68 [0.4-1.0], p=0.10). The use of balloon micro-catheter reduced the relative risk of the event of recurrence by 0.63 [CI95% 0.38-1.04]; p=0.07). No significant differences were found in AEs rate. Conclusion b-TACE showed a trend of better oncological response over DEM-TACE with and longer TTR with a similar adverse events rate, in patients presenting with larger tumors.

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Durable complete response is achieved by balloon‐occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

et al. 2022

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In 2013 and 2014, the development of microcatheters with balloons for the 4‐Fr system and new embolization materials provided various options for transarterial chemoembolization (TACE), expanding the range of treatment strategies. At our hospital, balloon‐occluded TACE (B‐TACE), conventional TACE (C‐TACE), and drug‐eluting bead TACE (DEB‐TACE) have been actively performed for hepatocellular carcinoma (HCC). This study compared the local recurrence‐free (LRF) periods of nodules with complete necrosis (TE4) obtained using each treatment method by extracting the nodules evaluated as complete response by the modified Response Evaluation Criteria in Solid Tumors. We performed 580 TACE procedures between June 2013 and April 2019. Among them, 58 HCC nodules in 43 patients, 33 nodules in 30 patients, and 45 nodules in 25 patients were evaluated as having complete necrosis after C‐TACE, DEB‐TACE, and B‐TACE, respectively. The time to local recurrence for each nodule was defined as the LRF period, and the quality of TE4 for each TACE was examined. Factors related to overall survival and the LRF period were determined by univariate and multivariate analyses, and overall survival and the LRF period were analyzed using the Kaplan–Meier method. Multivariate analysis of the LRF period showed that B‐TACE was an independent factor. The median LRF periods were 39.3, 13, and 9.1 months for B‐TACE, C‐TACE, and DEB‐TACE, respectively. Moreover, B‐TACE had a significantly longer LRF period than C‐TACE and DEB‐TACE. Conclusion : There was no significant difference between C‐TACE and DEB‐TACE. The LRF period of nodules with TE4 was the longest with B‐TACE, suggesting that B‐TACE should be used to achieve a radical cure in patients with HCC.

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Polyethylene Glycol Epirubicin-Loaded Transcatheter Arterial Chemoembolization Procedures Utilizing a Combined Approach with 100 and 200 μm Microspheres: A Promising Alternative to Current Standards

Cited by 14 publications

References 23 publications

Unresectable hepatocellular carcinoma treatment with doxorubicin-eluting polyethylene glycol microspheres: a single-center experience

Unresectable hepatocellular carcinoma treatment with doxorubicin-eluting polyethylene glycol microspheres: a single-center experience

Balloon Occluded TACE (B-TACE) vs DEM-TACE for HCC. A Single Center Retrospective Case Control Study.

Durable complete response is achieved by balloon‐occluded transcatheter arterial chemoembolization for hepatocellular carcinoma

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