TACE with degradable starch microspheres (DSM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib

the HepatoCatt Study Group

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To date, there is no approved second-line treatment for patients dismissing sorafenib or ineligible for this treatment, so it would be useful to find an effective alternative treatment option. The aim of our study was to evaluate safety, feasibility and effectiveness of transarterial chemoembolisation with degradable starch microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (sorafenib) due to unbearable side effects or clinical contraindications. Methods: Forty consecutive BCLC stage B or C patients (31 male; age, 70.6 ± 13.6 years), with intermediate or locally advanced HCC dismissing or ineligible for sorafenib administration, who underwent DSM-TACE treatment cycle via lobar approach were prospectively enrolled. Tumour response was evaluated on multidetector computed tomography based on mRECIST criteria. Primary endpoints were safety, tolerance and overall disease control (ODC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At 1-year follow-up, ODC of 52.5% was registered. PFS was 6.4 months with a median OS of 11.3 months. Conclusions: DSM-TACE is safe and effective as a second-line treatment in HCC patients dismissing or ineligible for sorafenib. Key Points: • DSM-TACE is safe and effective as second-line treatment in HCC patients dismissing or ineligible for sorafenib • DSM-TACE allows the temporary occlusion of the smaller arterial vessels, improving overall therapeutic effectiveness by reducing the immediate wash-out of the cytostatic agent • DSM-TACE also decreases the risk of systemic toxicity and post-embolic syndrome.

Original languageEnglish
JournalEuropean Radiology
DOIs
Publication statusAccepted/In press - Jan 1 2018

Fingerprint

Hepatocellular Carcinoma
Therapeutics
Disease-Free Survival
Safety
Survival
Multidetector Computed Tomography
sorafenib
degradable starch microspheres
Liver Failure
Cytostatic Agents
Drug Therapy
Neoplasms

Keywords

  • Chemoembolisation
  • Hepatocellular carcinoma
  • Precision medicine
  • Sorafenib
  • Therapeutic

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

TACE with degradable starch microspheres (DSM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib. / the HepatoCatt Study Group.

In: European Radiology, 01.01.2018.

Research output: Contribution to journalArticle

@article{4922c24b4dcc40709d12b73f443fd186,
title = "TACE with degradable starch microspheres (DSM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib",
abstract = "Objectives: To date, there is no approved second-line treatment for patients dismissing sorafenib or ineligible for this treatment, so it would be useful to find an effective alternative treatment option. The aim of our study was to evaluate safety, feasibility and effectiveness of transarterial chemoembolisation with degradable starch microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (sorafenib) due to unbearable side effects or clinical contraindications. Methods: Forty consecutive BCLC stage B or C patients (31 male; age, 70.6 ± 13.6 years), with intermediate or locally advanced HCC dismissing or ineligible for sorafenib administration, who underwent DSM-TACE treatment cycle via lobar approach were prospectively enrolled. Tumour response was evaluated on multidetector computed tomography based on mRECIST criteria. Primary endpoints were safety, tolerance and overall disease control (ODC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At 1-year follow-up, ODC of 52.5{\%} was registered. PFS was 6.4 months with a median OS of 11.3 months. Conclusions: DSM-TACE is safe and effective as a second-line treatment in HCC patients dismissing or ineligible for sorafenib. Key Points: • DSM-TACE is safe and effective as second-line treatment in HCC patients dismissing or ineligible for sorafenib • DSM-TACE allows the temporary occlusion of the smaller arterial vessels, improving overall therapeutic effectiveness by reducing the immediate wash-out of the cytostatic agent • DSM-TACE also decreases the risk of systemic toxicity and post-embolic syndrome.",
keywords = "Chemoembolisation, Hepatocellular carcinoma, Precision medicine, Sorafenib, Therapeutic",
author = "{the HepatoCatt Study Group} and Roberto Iezzi and Maurizio Pompili and Emanuele Rinninella and Eleonora Annicchiarico and Matteo Garcovich and Lucia Cerrito and Francesca Ponziani and {De Gaetano}, {Anna Maria} and Massimo Siciliano and Michele Basso and Zocco, {Maria Assunta} and Rapaccini, {Gian Lodovico} and Alessandro Posa and Francesca Carchesio and Marco Biolato and Felice Giuliante and Antonio Gasbarrini and Riccardo Manfredi",
year = "2018",
month = "1",
day = "1",
doi = "10.1007/s00330-018-5692-8",
language = "English",
journal = "European Radiology",
issn = "0938-7994",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - TACE with degradable starch microspheres (DSM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib

AU - the HepatoCatt Study Group

AU - Iezzi, Roberto

AU - Pompili, Maurizio

AU - Rinninella, Emanuele

AU - Annicchiarico, Eleonora

AU - Garcovich, Matteo

AU - Cerrito, Lucia

AU - Ponziani, Francesca

AU - De Gaetano, Anna Maria

AU - Siciliano, Massimo

AU - Basso, Michele

AU - Zocco, Maria Assunta

AU - Rapaccini, Gian Lodovico

AU - Posa, Alessandro

AU - Carchesio, Francesca

AU - Biolato, Marco

AU - Giuliante, Felice

AU - Gasbarrini, Antonio

AU - Manfredi, Riccardo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Objectives: To date, there is no approved second-line treatment for patients dismissing sorafenib or ineligible for this treatment, so it would be useful to find an effective alternative treatment option. The aim of our study was to evaluate safety, feasibility and effectiveness of transarterial chemoembolisation with degradable starch microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (sorafenib) due to unbearable side effects or clinical contraindications. Methods: Forty consecutive BCLC stage B or C patients (31 male; age, 70.6 ± 13.6 years), with intermediate or locally advanced HCC dismissing or ineligible for sorafenib administration, who underwent DSM-TACE treatment cycle via lobar approach were prospectively enrolled. Tumour response was evaluated on multidetector computed tomography based on mRECIST criteria. Primary endpoints were safety, tolerance and overall disease control (ODC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At 1-year follow-up, ODC of 52.5% was registered. PFS was 6.4 months with a median OS of 11.3 months. Conclusions: DSM-TACE is safe and effective as a second-line treatment in HCC patients dismissing or ineligible for sorafenib. Key Points: • DSM-TACE is safe and effective as second-line treatment in HCC patients dismissing or ineligible for sorafenib • DSM-TACE allows the temporary occlusion of the smaller arterial vessels, improving overall therapeutic effectiveness by reducing the immediate wash-out of the cytostatic agent • DSM-TACE also decreases the risk of systemic toxicity and post-embolic syndrome.

AB - Objectives: To date, there is no approved second-line treatment for patients dismissing sorafenib or ineligible for this treatment, so it would be useful to find an effective alternative treatment option. The aim of our study was to evaluate safety, feasibility and effectiveness of transarterial chemoembolisation with degradable starch microspheres (DSM-TACE) in the treatment of patients with advanced hepatocellular carcinoma (HCC) dismissing or ineligible for multikinase-inhibitor chemotherapy administration (sorafenib) due to unbearable side effects or clinical contraindications. Methods: Forty consecutive BCLC stage B or C patients (31 male; age, 70.6 ± 13.6 years), with intermediate or locally advanced HCC dismissing or ineligible for sorafenib administration, who underwent DSM-TACE treatment cycle via lobar approach were prospectively enrolled. Tumour response was evaluated on multidetector computed tomography based on mRECIST criteria. Primary endpoints were safety, tolerance and overall disease control (ODC); secondary endpoints were progression-free survival (PFS) and overall survival (OS). Results: Technical success was achieved in all patients. No intra/peri-procedural death/major complications occurred. No signs of liver failure or systemic toxicity were detected. At 1-year follow-up, ODC of 52.5% was registered. PFS was 6.4 months with a median OS of 11.3 months. Conclusions: DSM-TACE is safe and effective as a second-line treatment in HCC patients dismissing or ineligible for sorafenib. Key Points: • DSM-TACE is safe and effective as second-line treatment in HCC patients dismissing or ineligible for sorafenib • DSM-TACE allows the temporary occlusion of the smaller arterial vessels, improving overall therapeutic effectiveness by reducing the immediate wash-out of the cytostatic agent • DSM-TACE also decreases the risk of systemic toxicity and post-embolic syndrome.

KW - Chemoembolisation

KW - Hepatocellular carcinoma

KW - Precision medicine

KW - Sorafenib

KW - Therapeutic

UR - http://www.scopus.com/inward/record.url?scp=85052955040&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052955040&partnerID=8YFLogxK

U2 - 10.1007/s00330-018-5692-8

DO - 10.1007/s00330-018-5692-8

M3 - Article

AN - SCOPUS:85052955040

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -