Transarterial chemoembolization with medium-sized doxorubicin-eluting Callisphere is safe and effective for patients with hepatocellular carcinoma

Abstract

the study aimed to compare the tumor response to and complications of doxorubicin-eluting calliSphere bead-transarterial chemoembolization (DeB-tAce) using small-and medium-sized beads in patients with hepatocellular carcinoma (Hcc) who underwent multiple rounds of oncology therapies. Sixty patients with intermediate stage HCC who had previously received multiple oncology therapies underwent DEB-TACE with CalliSpheres of 100-300 μm (small bead group, n = 34) or 300-500 μm (medium bead group, n = 26) in diameter between October 2016 and December 2018. Adverse events and the response rate of the index tumor based on the modified Response Evaluation Criteria in Solid Tumors at 3 months post-TACE were compared between the groups. The rates of complete response, partial response, stable disease, and progressive disease were 35.4%, 29.4%, 17.6%, and 17.6%, respectively, for the small bead group and 33.1%, 23.1%, 20.8%, and 23.0%, respectively, for the medium bead group, showing no significant between-group differences (P > 0.05). Common Terminology Criteria for Adverse Events version 4.0 grade 3/4 adverse events were reported in 8 patients in the small bead group and in no patients in the medium bead group, showing a significant group difference (P < 0.01). Major complications included 8 events of ischemic hepatitis, 2 of biloma, and 2 of severe liver abscess. DEB-TACE using CalliSpheres of 300-500 μm was associated with a comparable rate of tumor response but lower rate of complications compared with that using calliSpheres of 100-300 μm for Hcc treatment in patients who had already undergone multiple rounds of oncology therapies.

Safety and efficacy of drug-eluting bead transarterial chemoembolization with CalliSpheres® microsphere for hepatocellular carcinoma with portal vein tumor thrombus: a preliminary study

“…Many pieces of research have proved that it can load more kinds of chemotherapy drugs and has a higher drug-loading efficiency compared with other DEBs [7][8][9]. According to several recent studies, unresectable HCC patients who receive DEB-TACE treatment using CSM have better treatment response, prolonged overall survival (OS) and reduced adverse events (AEs) compared with cTACE [10][11]. Therefore, the purpose of this study was to investigate the treatment efficacy and safety of DEB-TACE using CSM and to identify important prognostic factors related to the survival of HCC patients with PVTT.…”

Recent advances and applications of microspheres and nanoparticles in transarterial chemoembolization for hepatocellular carcinoma

“…Besides, the pharmacokinetic profile revealed the speed of drug‐eluting, which is critical to the treatment efficacy of TACE. Many studies compare the embolic particles with different sizes, such as 100–300 versus 700–900 μm, 100–300 versus 300–500 and 500–700 μm, 100–300 versus 300–500 μm, and 70–150 versus 100–300 μm (Namur et al, 2010; Padia et al, 2013; Prajapati et al, 2014; Wang et al, 2020). A preliminary study found that the DOX‐loaded LC/DC Beads with 100–300 μm size employed a higher necrosis rate than 700–900 μm beads.…”

A Four-Step Cascade Drug-Release Management Strategy for Transcatheter Arterial Chemoembolization (TACE) Therapeutic Applications

“…Therefore, it is essential that the embolic microsphere has a suitable diameter for TACE, which is based on blood vessel size. The size of microspheres used for TACE in clinical trials has ranged from 50 to 500 µm [33]. To evaluate the size variation in the GG and GG/AFGO-Dox microspheres, their diameter was measured using a laser diffraction particle size analyzer.…”