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

Roberto Iezzi, Maurizio Pompili, Maria Assunta Zocco, Felice Giuliante, Antonio Gasbarrini, Riccardo Manfredi, Emanuele Rinninella, Brigida Eleonora Annicchiarico, Francesca Romana Ponziani, Anna Maria De Gaetano, Massimo Siciliano, Michele Basso, Marco Biolato

Risultato della ricerca: Contributo in rivistaArticolo in rivista

8 Citazioni (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.
Lingua originaleEnglish
pagine (da-a)1285-1292
Numero di pagine8
RivistaEuropean Radiology
Volume29
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Chemoembolisation
  • Hepatocellular carcinoma
  • Precision medicine
  • Radiology, Nuclear Medicine and Imaging
  • Sorafenib
  • Therapeutic

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