Postoperative Adjuvant Transarterial Infusion Chemotherapy with FOLFOX Could Improve Outcomes of Hepatocellular Carcinoma Patients with Microvascular Invasion: A Preliminary Report of a Phase III, Randomized Controlled Clinical Trial

Li, Shaohua; Mei, Jie; Wang, Qiaoxuan; Guo, Zhixing; Lu, Lianghe; Ling, Yihong; Xu, Li; Chen, Minshan; Zheng, Lie; Lin, Wenping; Zou, Jingwen; Wen, Yang; Wei, Wei; Guo, Rong

doi:10.1245/s10434-020-08601-8

Cited by 30 publications

(26 citation statements)

References 23 publications

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“…Another 27 more records were excluded after reading the full text, with the following reasons: 1) 18 records of patients undergoing other combined therapies; 2) five records not written in English; 3) two records of review articles; 4) one record of patients with overlapped cohort; and 5) one record of a non-comparative group. Finally, 12 records were assessed to be eligible for this meta-analysis ( 12 , 13 , 21 – 30 ), including two RCTs ( 13 , 26 ) and 10 non-RCTs ( 12 , 21 – 25 , 27 – 30 ) ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of note, there were apparent differences among the included studies in the median OS and DFS, which are shown in Table 1 . The quality of each enrolled study is also exhibited in Table 1 , among which eight were assessed as high-quality ones ( 13 , 23 – 28 , 30 ) and four as medium-quality ones ( 12 , 21 , 22 , 29 ).…”

Section: Resultsmentioning

confidence: 99%

“…( 12 ) first identified the role of adjuvant HAIC in 1991 in a report of 19 HCC patients after hepatectomy, but the results of subsequent studies did not exactly correspond to those of a previous study. In the recent two randomized controlled trials (RCTs) ( 13 , 14 ), adjuvant HAIC was found to bring survival benefits to HCC patients in both OS and DFS, but both their sample sizes are too small. Hence, we wanted to systematically review the literatures on postoperative adjuvant HAIC for HCC, and then we conducted a meta-analysis comparing the long-term efficacy of SR+HAIC versus SR alone.…”

Section: Introductionmentioning

confidence: 99%

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Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Wang

Wei

et al. 2021

Front. Oncol.

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BackgroundTo systematically identify the long-term efficacy of postoperative adjuvant hepatic artery infusion chemotherapy (HAIC) for patients with hepatocellular carcinoma (HCC).MethodsPubMed, MedLine, Embase, the Cochrane Library, and Web of Science were searched to collect the eligible studies up to March 31, 2021, that compared the surgical resection (SR) versus SR+HAIC for HCC patients. The endpoints were overall survival (OS) rates and disease-free survival (DFS) rates, and the effect size was determined by hazard ratio (HR) with 95% CI.ResultsA total of 12 studies (two randomized controlled trials (RCTs) and 10 non-RCTs) including 1,333 patients were eligible for this meta-analysis. The pooled results showed that OS and DFS rates in the SR+HAIC group were both better than those in the SR alone group (HR = 0.56, 95% CI = 0.41–0.77, p < 0.001; HR = 0.66, 95% CI = 0.55–0.78, p < 0.001, respectively). Furthermore, the subgroup analysis showed that patients would benefit from SR+HAIC regardless of chemotherapy regimens and courses (all p < 0.05), and patients with microvascular or macrovascular invasion would also benefit more from SR+HAIC in terms of OS and DFS (all p < 0.05).ConclusionPostoperative adjuvant HAIC could improve the long-term prognosis of HCC patients, especially for those with microvascular or macrovascular invasion, regardless of chemotherapy regimens and courses, but it deserves further validation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Wang

Wei

et al. 2021

Front. Oncol.

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“…The first use of PD-1 inhibitors was within 7 days of initiation of lenvatinib. For the HPL group, HAIC was administered according to previously described procedures ( 11 ). Femoral artery puncture and catheterization were performed in every cycle of treatment.…”

Section: Methodsmentioning

confidence: 99%

Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Inhibitors Plus Lenvatinib Versus PD-1 Inhibitors Plus Lenvatinib for Advanced Hepatocellular Carcinoma

et al. 2021

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BackgroundLenvatinib combined with programmed cell death protein-1 (PD-1) inhibitors has resulted in good survival outcomes in the treatment of unresectable hepatocellular carcinoma (HCC). Hepatic artery infusion chemotherapy (HAIC) has also attracted attention due to its high response rates and favorable survival for advanced HCC patients. The present study aimed to compare the efficacy of HAIC combined with PD-1 inhibitors plus lenvatinib (HPL) and PD-1 inhibitors plus lenvatinib (PL) in patients with advanced HCC.MethodsBetween July 2018 and December 2019, patients diagnosed with advanced HCC who initially received HPL or PL treatment were reviewed for eligibility. Efficacy was evaluated according to tumor response and survival.ResultsIn total, 70 patients met the criteria and were included in the present study, and they were divided into the HPL group (n = 45) and PL group (n = 25). The overall response rate (40.0 vs. 16.0%, respectively; p = 0.038) and disease control rate (77.6 vs. 44.0%, respectively; p < 0.001) were higher in the HPL group than in the PL group. The median overall survival was 15.9 months in the HPL group and 8.6 months in the PL group (p = 0.0015; HR = 0.6; 95% CI 0.43–0.83). The median progression-free survival was 8.8 months in the HPL group and 5.4 months in the PL group (p = 0.0320; HR = 0.74; 95% CI 0.55–0.98).ConclusionCompared to PL, HPL was associated with a significantly better treatment response and survival benefits for patients with advanced HCC.

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“…HAIC was administered according to previously described procedures. 18 Femoral artery puncture and catheterization were performed in every cycle of treatment. The FOLFOX regimen was administered via the hepatic artery as follows: 85 or 135 mg/m 2 oxaliplatin, 400 mg/m 2 leucovorin, and 400 mg/m 2 fluorouracil on the first day; and 2400 mg/m 2 fluorouracil over 46 hours.…”

Section: Methodsmentioning

confidence: 99%

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

Mei¹,

Li²,

Li³

et al. 2021

JHC

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Background Hepatic artery infusion chemotherapy (HAIC) and anti-programmed cell death protein-1 (PD-1) immunotherapy have shown promising outcomes in patients with advanced hepatocellular carcinoma (HCC), respectively. However, the combination of the two treatments has not been reported. In this study, we compared the efficacy of HAIC combined with anti-PD-1 immunotherapy (HAICAP) and HAIC in patients with advanced HCC. Methods Between November 2018 and December 2019, advanced HCC patients that were treated with either HAICAP or HAIC were retrospectively recruited and reviewed for eligibility. Efficacy was evaluated according to tumor response and survival. Results As a result, 229 patients were included in this study. Patients were divided into HAICAP group (n = 81) and HAIC group (n = 148) accordingly. The follow-up time ranged from 1.0 to 21.6 months, with a median of 11.0 months. The median overall survival was 18.0 months in the HAICAP group and 14.6 months in the HAIC group (p = 0.018; HR = 0.62; 95% CI 0.34–0.91). The median progression-free survival was 10.0 months in the HAICAP group and 5.6 months in the HAIC group (p = 0.006; HR = 0.65; 95% CI 0.43–0.87). The disease control rate in overall response (83% vs 66%; p = 0.006) and intrahepatic response (85% vs 74%, respectively; p = 0.045) were higher in the HAICAP group than in the HAIC group. Conclusion In comparison to HAIC, HAICAP was associated with a better treatment response and survival benefits for patients with advanced HCC.

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Postoperative Adjuvant Transarterial Infusion Chemotherapy with FOLFOX Could Improve Outcomes of Hepatocellular Carcinoma Patients with Microvascular Invasion: A Preliminary Report of a Phase III, Randomized Controlled Clinical Trial

Cited by 30 publications

References 23 publications

Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Inhibitors Plus Lenvatinib Versus PD-1 Inhibitors Plus Lenvatinib for Advanced Hepatocellular Carcinoma

Anti-PD-1 Immunotherapy Improves the Efficacy of Hepatic Artery Infusion Chemotherapy in Advanced Hepatocellular Carcinoma

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