Transarterial Chemoembolization with Small Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: Experience from a Cohort of 421 Patients at an Italian Center

Aliberti, Camillo; Carandina, Riccardo; Lonardi, Sara; Dadduzio, Vincenzo; Vitale, Alessandro; Gringeri, Enrico; Zanus, Giacomo; Cillo, Umberto

doi:10.1016/j.jvir.2017.07.020

Cited by 46 publications

(63 citation statements)

References 22 publications

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“…In this current study, all patients were discharged within one day of DEB‐TACE. This high rate of discharge is concordant with similar study by Aliberti and colleagues with mean hospital stay of 1 day (range: 1–2 days) . The rate of severe (grade 3/4) adverse events related to DEB‐TACE occurring within 30 days was low in our study.…”

Section: Discussionsupporting

confidence: 92%

“…Patients treated with 70–150 μm DEB particles were significantly less likely to have progressive disease on 1‐month follow‐up tumour imaging compared those treated with 100–300 μm DEB sizes (3.8% vs. 33.3%, odds ratio 7.15, P = 0.007). These outcomes are similar to the outcomes by Aliberti and colleagues with 70–150 μm DEB beads . We hypothesise that the main contributing factor for the higher tumour response with smaller 70‐150 μm beads may be the more consistent distal penetration into the tumour, achieving a more precise and greater dose.…”

Section: Discussionsupporting

confidence: 86%

“…Over the years, studies have demonstrated a reduction in complications and improvement in outcomes with smaller DEB sizes . The first few studies used either 500–700 µm and/or 300–500 µm DC beads such as the initial PRECISION I and II studies, the later randomised phase II trial PRECISION V and the study by Dhanasekaran and colleagues, which demonstrated improved outcomes over cTACE.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, the most recent consensus recommendations suggest use of 100–300 µm DEBs . However, a recent single‐arm study by Aliberti et al with 70–150 μm sized DEB has shown impressive overall response rates and median overall survival of 42 months . There have only been a few studies comparing tumour response and safety of 70–150 μm vs. 100–300 μm DEB particles …”

Section: Discussionmentioning

confidence: 99%

“…100–300 μm) for DEB‐TACE demonstrate a significantly higher survival rate, improved tumour response and fewer complications than the 300–500 μm and/or 500–700 μm sized DEB . More recently, 70–150 μm sized DEB has shown impressive overall response rates of 99.5% at 6 months with a median overall survival of 42.0 months . There have been few small retrospective studies in the literature, which have compared the outcomes of 70–150 μm vs. 100–300 μm DEB particles …”

Section: Introductionmentioning

confidence: 99%

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Survival, tumour response and safety of 70‐150 μm versus 100‐300 μm doxorubicin drug‐eluting beads in transarterial chemoembolisation for hepatocellular carcinoma

et al. 2019

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Introduction This study investigates the outcomes and safety of 70–150 μm and 100–300 μm doxorubicin drug‐eluting bead transarterial chemoembolisation (DEB‐TACE) in patients with unresectable hepatocellular carcinoma (HCC). Methods Retrospective, cohort study of 51 patients treated with DEB‐TACE for unresectable HCC was studied: 23 with 100–300 μm particles and 28 with 70–150 μm particles. Overall, survival (OS), progression‐free survival (PFS), tumour response and prognostic factors were assessed. Results The median OS of the entire cohort was 30 months. The median OS and median PFS for 70–150 μm particles were not reached, whilst for the 100–300 μm group, it was 29.2 months and 15.0 months, respectively. The 6‐month, 1‐year and 2‐year OS for 70–150 μm was 96%, 86% and 85% versus the 100–300 μm particles size of 83%, 64% and 44%, respectively. At 1‐month follow‐up, patients treated with 70–150 μm had significantly better mRECIST tumour response compared to 100–300 μm (complete response 38.5% vs. 19%; partial response 57.7% vs. 42.9%; stable disease 0% vs. 4.8%; progressive disease 3.8% vs. 33.3%, P = 0.027). Patients treated with 100–300 μm DEBs were significantly more likely to have progressive disease on 1‐month follow‐up imaging compared those treated with 70–150 μm DEB sizes (odds ratio 7.15, P = 0.007). The 30‐day mortality rate was similar between the two groups (3.6% for 70–150 μm vs. 4.3% for 100–300 μm). Multivariate analysis demonstrated entire cohort OS was significantly associated with BCLC stage (aHR: 10.5, P = 0.002), albumin (aHR: 15.0, P = 0.02) and ALP (aHR 62, P = 0.001). Conclusions DEB‐TACE with 70–150 μm particles demonstrates improved 1‐month objective tumour response compared to 100–300 μm, whilst having a similar safety profile. Elevated ALP, lower albumin and higher BCLC stage were significantly associated with poorer survival outcomes.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Survival, tumour response and safety of 70‐150 μm versus 100‐300 μm doxorubicin drug‐eluting beads in transarterial chemoembolisation for hepatocellular carcinoma

et al. 2019

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Recent Progress in Advanced Hydrogel‐Based Embolic Agents: From Rational Design Strategies to Improved Endovascular Embolization

Ullah

et al. 2023

Adv Healthcare Materials

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Transcatheter arterial embolization, a minimally invasive treatment to deliberately occlude the blood vessels, has become a safe and effective procedure for the management of vascular diseases and benign/malignant tumors. Particularly, hydrogel‐based embolic agents have garnered much attention because of their potential to address some of the limitations of clinically used embolic agents and can be rationally designed to impart more favorable characteristics or functions. In this review, the recent progress toward the development of polymer‐based hydrogels for effective endovascular embolization, including the in situ gelling hydrogels mediated by physically or chemically crosslinking, imageable hydrogels for intraprocedural and postprocedural feedback, use of hydrogels as the drug depot for local delivery of therapeutic drugs, hemostatic hydrogels inducing extrinsic or intrinsic coagulation of blood, stimuli‐responsive shape memory hydrogels as the smart embolization devices, and hydrogels incorporating external‐stimuli functional materials for multidisciplinary therapy, is systemically summarized. Moreover, the potential considerations of hydrogel‐based embolic agents confronted in therapeutic embolization are pointed out. Finally, the perspectives for the development of more effective embolic hydrogels are also highlighted.

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

Valkenburgh

Chen

et al. 2021

WIREs Nanomed Nanobiotechnol

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Transarterial chemoembolization (TACE) is a recommended treatment for patients suffering from intermediate and advanced hepatocellular carcinoma (HCC). As compared to the conventional TACE, drug‐eluting bead TACE demonstrates several advantages in terms of survival, treatment response, and adverse effects. The selection of embolic agents is critical to the success of TACE. Many studies have been performed on the modification of the structure, size, homogeneity, biocompatibility, and biodegradability of embolic agents. Continuing efforts are focused on efficient loading of versatile chemotherapeutics, controlled sizes for sufficient occlusion, real‐time detection intra‐ and post‐procedure, and multimodality imaging‐guided precise treatment. Here, we summarize recent advances and applications of microspheres and nanoparticles in TACE for HCC. This article is categorized under: Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

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Transarterial Chemoembolization with Small Drug-Eluting Beads in Patients with Hepatocellular Carcinoma: Experience from a Cohort of 421 Patients at an Italian Center

Cited by 46 publications

References 22 publications

Survival, tumour response and safety of 70‐150 μm versus 100‐300 μm doxorubicin drug‐eluting beads in transarterial chemoembolisation for hepatocellular carcinoma

Survival, tumour response and safety of 70‐150 μm versus 100‐300 μm doxorubicin drug‐eluting beads in transarterial chemoembolisation for hepatocellular carcinoma

Recent Progress in Advanced Hydrogel‐Based Embolic Agents: From Rational Design Strategies to Improved Endovascular Embolization

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

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