Role of Transarterial Chemoembolization in the Treatment of Hepatocellular Carcinoma

Zhong, Bin-Yan; Jin, Zhicheng; Chen, Jian-Jia; Zhu, Hai-Dong; Zhu, Xiaoli

doi:10.14218/jcth.2022.00293

Cited by 30 publications

(36 citation statements)

References 87 publications

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“…According to the concept of treatment stage migration, TACE can be recommended for patients with early stage HCC in whom the recommended treatments are not feasible or have failed 2 . There are discrepancies between the East and the West regarding the indications of TACE for HCC 15,30 . The CNLC staging system provided relatively broad indications for TACE from Ib to IIIb, equivalent to part of the BCLC A and C stages and the entire B stage 4 .…”

Section: Overview Of Locoregional Therapiesmentioning

confidence: 99%

“…On another front, the integration of LRTs with systemic therapies has been explored for over a decade, yet only a few studies have achieved successful outcomes. In the current era of cancer immunotherapy, emerging evidence suggests that integrating LRTs and immune checkpoint inhibitors (ICIs) could offer substantial therapeutic advantages 9,13–15 . Although numerous randomised controlled trials (RCTs) are ongoing to evaluate these combination therapies, their adoption in real‐world clinical settings has already yielded promising results 16,17 .…”

Section: Introductionmentioning

confidence: 99%

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Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Chen,

Jin,

Zhong

et al. 2024

UEG Journal

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Hepatocellular carcinoma (HCC) is one of the most common cancers and a leading cause of cancer‐related mortality. Locoregional therapies (LRTs) play a crucial role in HCC management and are selectively adopted in real‐world practice across various stages. Choosing the best form of LRTs depends on technical aspects, patient clinical status and tumour characteristics. Previous studies have consistently highlighted the efficacy of combining LRTs with molecular targeted agents in HCC treatment. Recent studies propose that integrating LRTs with immune checkpoint inhibitors and molecular targeted agents could provide substantial therapeutic benefits, a notion underpinned by both basic and clinical evidence. This review summarised the current landscape of LRTs in HCC and discussed the anticipated outcomes of combinations with immunotherapy regimens.

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Section: Overview Of Locoregional Therapiesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Chen,

Jin,

Zhong

et al. 2024

UEG Journal

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“…[1,2] For patients with intermediate and advanced stage HCC, transarterial chemoembolization (TACE) and systemic therapy have become the standard recommendations according to global guidelines, respectively. [3][4][5] HCC frequently develops in patients with cirrhosis, which negatively affects prognosis. [6] In addition to being a prognostic factor for overall survival (OS) in patients with HCC, baseline liver function might also in uence treatment e cacy and safety.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Safety of Transarterial Chemoembolization Combined with PD-1 Inhibitors plus Molecular Targeted Therapies for Unresectable Hepatocellular Carcinoma with Child‒Pugh B

Huang,

Hong,

et al. 2024

Preprint

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Background and Objectives To assess the efficacy and safety of transarterial chemoembolization (TACE) combined with programmed cell death-1 (PD-1) inhibitors plus molecular targeted therapies (MTT) for unresectable hepatocellular carcinoma (HCC) with Child-Pugh (CP)-B (score of 7-8). Methods This multicenter retrospective study enrolled patients with unresectable HCC receivingTACE combined with PD-1 inhibitors plus MTT between January 2019 and December 2022. Propensity score matching (PSM) was performed to reduce bias between the CP-A and CP-B (score of 7-8) groups. The primary outcome was overall survival (OS)and the secondary outcomes included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), and adverse events (AEs). Results A total of 416 patients were ultimately included in the study. The median OS was 26.4 months (95% CI, 22.7-30.0) for the overall population during a median follow-up period of 32.5 months. The median OS was greater in patients with CP-A liver function than in patients with CP-B (score of 7-8), but the difference was not statistically significant. After PSM, the OS, PFS, ORR, and DCR of CP-A patients were comparable to those of CP-B (score of 7-8) patients. No significant difference was observed in the incidence of grade 3/4 AEs between the two groups. Conclusions Unresectable HCC patients with CP-B (score of 7-8) undergoing TACE combined with PD-1 inhibitors plus MTT showed similar clinical activity and safety profiles compared to CP-A patients.

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“…According to the Barcelona Clinic Liver Cancer (BCLC) clinical staging system, transarterial chemoembolization (TACE) is recommended as first-line therapy for HCC patients in BCLC stage B ( 3 ). Compared with supportive therapy, TACE significantly improved clinical outcomes and provided a survival benefit ( 4 ). However, TACE frequently results in incomplete tumor necrosis, eventually becoming less effective ( 5 ).…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of hepatic artery infusion chemotherapy combined with tyrosine kinase inhibitors plus programmed death-1 inhibitors for hepatocellular carcinoma refractory to transarterial chemoembolization

Lin

Yan

et al. 2023

Front. Oncol.

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BackgroundThe subsequent therapy for hepatocellular carcinoma (HCC) patients with refractory to transarterial chemoembolization (TACE) is still controversial. This study was performed to evaluate the efficacy and safety of combination therapy comprising hepatic artery infusion chemotherapy (HAIC), lenvatinib, and programmed death-1 inhibitors relative to HAIC combined with lenvatinib.MethodsIn this single-center retrospective study, we analyzed data from HCC patients with refractory to TACE from June 2017 to July 2022. Primary study outcomes were overall survival (OS) and progression-free survival (PFS), while the secondary outcomes were the objective response rate (ORR), disease control rate (DCR), and treatment-related adverse events.ResultsWe enrolled 149 patients finally, including 75 patients who received HAIC combined with lenvatinib plus PD-1 inhibitors therapy (HAIC+L+P group) and 74 patients who received HAIC combined with lenvatinib therapy (HAIC+L group). The median OS in the HAIC+L+P group (16.0; 95% CI: 13.6~18.3 months) was significantly higher compared to the HAIC+L group (9.0; 95% CI: 6.5~11.4 months) (p = 0.002), while the median PFS in the HAIC+L+P group (11.0; 95% CI: 8.6~13.3 months) was significantly higher compared to the HAIC+L group (6.0; 95% CI: 5.0~6.9 months) (p < 0.001). Significant between-group differences in DCR (p = 0.027) were found. Additionally, 48 pairs of patients were matched after propensity matching analysis. The survival prognosis between two groups before propensity matching is similar to that after propensity matching. Moreover, the percentage of patients with hypertension in the HAIC+L+P group was significantly higher compared to the HAIC+L group (28.00% vs. 13.51%; p = 0.029).ConclusionsA combination therapy of HAIC, lenvatinib, and programmed death-1 inhibitors significantly improved oncologic response and prolonged survival duration, showing a better survival prognosis for HCC patients with refractory toTACE.

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Role of Transarterial Chemoembolization in the Treatment of Hepatocellular Carcinoma

Cited by 30 publications

References 87 publications

Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Locoregional therapies for hepatocellular carcinoma: The current status and future perspectives

Efficacy and Safety of Transarterial Chemoembolization Combined with PD-1 Inhibitors plus Molecular Targeted Therapies for Unresectable Hepatocellular Carcinoma with Child‒Pugh B

Efficacy and safety of hepatic artery infusion chemotherapy combined with tyrosine kinase inhibitors plus programmed death-1 inhibitors for hepatocellular carcinoma refractory to transarterial chemoembolization

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