Practice patterns and deterioration of liver function after transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): Final analysis of OPTIMIS in Europe and Canada

Raoul, Jean-Luc; Decaens, Thomas; Burak, Kelly W.; Koskinas, John; Villadsen, Gerda Elisabeth; Heurgué–Berlot, Alexandra; Bayh, Inga; Cheng, Ann Lii; Kudo, Masatoshi; Lee, H.C.; Nakajima, Keiko; Peck‐Radosavljevic, Markus

doi:10.1093/annonc/mdy282.093

Cited by 6 publications

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“…Failure to benefit from prior local or regional therapies should trigger early consideration of systemic treatment. In addition, recent abstract data from the large international optimis study 84 showed an improvement in overall survival (os) for patients starting early on sorafenib therapy upon assessment of standard tace ineligibility compared with patients receiving no sorafenib at that time. The same study also demonstrated that, in a real-world experience, deviation from treatment guidelines for tace and not starting sorafenib (systemic therapy) are common and detrimental.…”

Section: Qualifying Statements For Recommendationmentioning

confidence: 99%

Nonsurgical Management of Advanced Hepatocellular Carcinoma: A Clinical Practice Guideline

et al. 2020

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Background Practice guidelines based on a systematic review of the literature regarding the nonsurgical management of hepatocellular carcinoma (hcc) in North America are lacking. Resection and transplantation are the foundations for cure of hcc; however, most patients are diagnosed at an advanced stage, precluding those curative treatments. A number of local or regional therapies are used and are followed by systemic therapy for advanced or progressive disease. Other treatments are available, but their efficacy, compared with those standards, is not well known. Methods First, systematic review questions were developed. Literature searches of the medline, embase, and Cochrane library databases (January 2000 to July 2018 or January 2005 to July 2018 depending on the question) were conducted; in addition, abstracts from the 2018 annual meeting of the American Society of Clinical Oncology were reviewed. A practice guideline was drafted that was then scrutinized by internal and external reviewers. Results Seventy-seven studies were included in the guideline: no guidelines, two systematic reviews, and seventyfive primary studies published in full (including one pooled analysis). Five recommendations were developed. Conclusions There is no evidence for or against the use of local or regional interventions other than transarterial chemoembolization for the treatment of intermediate- or advanced-stage hcc. Furthermore, there is no evidence to support the addition of sorafenib to any local or regional therapy. Sorafenib or lenvatinib are recommended for firstline systemic treatment of intermediate-stage hcc. Regorafenib or cabozantinib provide survival benefits when given as second-line treatment. Antiviral treatment is recommended in individuals with advanced hcc who are positive for the hepatitis B surface antigen.

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Section: Qualifying Statements For Recommendationmentioning

confidence: 99%

Nonsurgical Management of Advanced Hepatocellular Carcinoma: A Clinical Practice Guideline

et al. 2020

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“…Both TACTICS trials and this study con rmed that the combination therapy was superior to TACE alone, but more patients with higher malignancy were included in this study [15,16]. An important reason for the positive results of the TACTICS study might be that more than half of the patients with initial combination therapy were included in the study.A large, multicenter, prospective, noninterventional study (OPTIMIS study [21])showed that, early combination with sorafenib can prolong the median OS. A national cohort study based on a large sample (TACE combined with sorafenib group,n=426; sorafenib as a control group, n=168) showed that in BCLC stage C and liver function (Child-Pugh A) patients showed consistency, this trial fully con rmed the survival bene t of combination therapy for patients with advanced liver function reserve (median OS were 381days and 204 days,respectively; P=0.021 [22].…”

Section: Discussionmentioning

confidence: 99%

Effects of TACE combined with sorafenib on survival of patients with hepatocellular carcinoma based on ALBI grades and tumor load layers And Establishment of prognosis prediction model

Qie

Shi

Zhao

et al. 2022

Preprint

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BackgroundHepatocellular Carcinoma (HCC) is the fourth most common malignant tumor in China and the second leading cause of cancer-related death. Transcatheter arterial chemoembolization (TACE) and targeted therapy are widely used in the treatment of HCC. To make a better treatment strategy from many treatment options, this study analyzed the survival of patients with liver cancer based on Albumin-Bilirubin (ALBI) grades and tumor load layer, and established a nomogram model. MethodsThe clinical data of 354 patients with unresectable HCC and recurrent HCC after radical resection who received TACE combined with or without sorafenib(SORA) in our hospital from 2017 to 2020 were investigated retrospectively.After 1:2 propensity score matching (PSM), eighty-one cases in TACE + SORA group and 162 cases in TACE group were included. ResultsThe survival bene t of TACE combined with sorafenib is better than that of TACE alone in patients with advanced liver cancer and recurrent primary liver cancer after radical surgery. Compared with TACE alone, patients with good liver function reserve (ALBI grade 1_5 points) can bene t signi cantly from TACE combined with SORA (median PFS: 11.8 months vs 7.0 months, P=0.000; median OS: 27.6 months vs 23.0 months, P=0.019). For patients with poor liver function (such as ALBI grade 1_ grade B), combined therapy can not signi cantly prolong the survival of patients with liver cancer(median PFS: P=0.370; median OS: P=0.131). ALBI grades is superior to Child-Pugh grades in predicting the prognosis of HCC. The prognosis of patients with large tumor burden ((layer 2 and layer 3) is better than that of patients with TACE alone(layer 2: 24.5 months vs 18.5 months, layer 3: 15.0 months vs 12.2 months; P<0.05). The nomogram prediction model can predict the prognosis of patients with unresectable liver cancer and patients with recurrence of liver cancer(C-index and AUC: 0.846 and 0.703, respectively)(C index range in predicting OS in 1, 2 and 3 years: 0.707-0.928), and it is also a good risk strati cation model. Nomograph model based on ALBI grades is better than nomograph model based on Child-Pugh grades (0.844 vs 0.839). ConclusionsCompared with TACE alone, the combination of TACE and sorafenib could improve the prognosis of patients, especially the patients with better liver function (ALBI grade 1_5points) and the patients with higher tumor load,such as layer 2 and 3. The nomogram model established in this study performed well in predicting prognosis, and the model could be used for risk strati cation of patients. BackgroundAccording to the latest global cancer burden datas in 2020 released by the International Agency for Research on Cancer (IARC) of the World Health Organization [1], the incidence rate of hepatocellular carcinoma was fth in China, second in mortality. Almost 70% of patients of HCC were in the middle or later stages (Barcelona Clinic Liver Cancer stage [BCLC] B or C) the opportunity of radical treatments such as surgical operation, liver transplantation and ablation has been los...

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“…TACE is one of the most widely used palliative treatments in the world. However, repeated chemoembolisation sessions can lead to impaired liver functions, limiting access to subsequent systemic treatments, and cohort studies have shown that only <20% of patients treated with chemoembolisation will be able to receive systemic treatment [ 75 ]. In addition, patients with intermediate-stage HCC constitute a very heterogeneous group, and some systems for subclassification (based in particular on CP score, beyond Milan, and up-to-seven criteria [ 76 , 77 ]) have been proposed to identify patients who will not benefit from TACE [ 78 , 79 ].…”

Section: Emerging Strategiesmentioning

confidence: 99%

Is There Still a Place for Tyrosine Kinase Inhibitors for the Treatment of Hepatocellular Carcinoma at the Time of Immunotherapies? A Focus on Lenvatinib

Decraecker

Toulouse

Blanc

2021

Cancers

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The systemic treatment of hepatocellular carcinoma is changing rapidly. Three main classes of treatment are now available. Historically, multi-targeted tyrosine kinase inhibitors (TKIs) (sorafenib and lenvatinib as first-line; regorafenib and cabozantinib as second-line) were the first to show an improvement in overall survival (OS). Anti-vascular endothelial growth factor (anti-VEGF) antibodies can be used in first-line (bevacizumab) or second-line (ramucirumab) combination therapy. More recently, immuno-oncology (IO) has profoundly changed therapeutic algorithms, and the combination of atezolizumab-bevacizumab is now the first-line standard of care. Therefore, the place of TKIs needs to be redefined. The objective of this review was to define the place of TKIs in the therapeutic algorithm at the time of IO treatment in first-line therapy, with a special focus on lenvatinib that exhibits one of the higher anti-tumoral activity among TKI in HCC. We will discuss the place of lenvatinib in first line (especially if there is a contra-indication to IO) but also after failure of atezolizumab and bevacizumab. New opportunities for lenvatinib will also be presented, including the use at an earlier stage of the disease and combination with IOs.

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Practice patterns and deterioration of liver function after transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): Final analysis of OPTIMIS in Europe and Canada

Cited by 6 publications

References 0 publications

Nonsurgical Management of Advanced Hepatocellular Carcinoma: A Clinical Practice Guideline

Nonsurgical Management of Advanced Hepatocellular Carcinoma: A Clinical Practice Guideline

Effects of TACE combined with sorafenib on survival of patients with hepatocellular carcinoma based on ALBI grades and tumor load layers And Establishment of prognosis prediction model

Is There Still a Place for Tyrosine Kinase Inhibitors for the Treatment of Hepatocellular Carcinoma at the Time of Immunotherapies? A Focus on Lenvatinib

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