Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma

Shota Ueda,1 Shinichi Hori,2 Atsushi Hori,2 Kazuhiro Makitani,2 Ke Wan,3 Tetsuo Sonomura1 1Department of Radiology, Wakayama Medical University, Wakayama, Japan; 2Department of Radiology, Institute for Image Guided Therapy, Izumisano City, Osaka, Japan; 3Clinical Study Support Center, Wakayama Medic...

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Main Authors: Ueda S, Hori S, Hori A, Makitani K, Wan K, Sonomura T
Format: Article
Language:English
Published: Dove Medical Press 2022-09-01
Series:Journal of Hepatocellular Carcinoma
Subjects:
Online Access:https://www.dovepress.com/retrospective-study-of-the-efficacy-and-safety-of-chemoembolization-wi-peer-reviewed-fulltext-article-JHC
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author Ueda S
Hori S
Hori A
Makitani K
Wan K
Sonomura T
author_facet Ueda S
Hori S
Hori A
Makitani K
Wan K
Sonomura T
author_sort Ueda S
collection DOAJ
description Shota Ueda,1 Shinichi Hori,2 Atsushi Hori,2 Kazuhiro Makitani,2 Ke Wan,3 Tetsuo Sonomura1 1Department of Radiology, Wakayama Medical University, Wakayama, Japan; 2Department of Radiology, Institute for Image Guided Therapy, Izumisano City, Osaka, Japan; 3Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, JapanCorrespondence: Shota Ueda, Department of Radiology, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan, Tel/Fax +81-73-441-0605, Email uedaaa@wakayama-med.ac.jpPurpose: To evaluate the efficacy and safety of chemoembolization with drug-eluting microspheres (DEM-TACE) combined with intra-arterial infusion of bevacizumab in patients with unresectable hepatocellular carcinoma (uHCC) and to identify possible prognostic factors.Patients and Methods: Between November 2014 and December 2020, 34 patients underwent DEM-TACE combined with intra-arterial infusion of bevacizumab for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) beyond the Up-to-seven criteria or BCLC stage C HCC. Patients with extrahepatic metastasis or inferior vena cava invasion were excluded. The primary endpoint was overall survival (OS). The secondary endpoints were safety (assessed using Common Terminology Criteria for Adverse Events v5.0), the response rate at 1 month, and the identification of prognostic factors. The median OS was calculated using the Kaplan–Meier method. The response rate was evaluated according to the modified Response Evaluation Criteria in Solid Tumors. Prognostic factors were investigated by univariate and multivariable analysis using the Cox proportional hazards model.Results: The median OS was 13 months. BCLC stage and presence of portal vein invasion were not significantly associated with OS. There were no grade ≥ 3 adverse events. The Child–Pugh class did not decline after treatment in 31 of 34 patients. The overall response rate was 14.2% and the disease control rate was 100%. Significant prognostic factors were alcoholic liver disease, Child–Pugh score of ≥ 8, and microsphere size of 50– 100 μm.Conclusion: DEM-TACE combined with intra-arterial infusion of bevacizumab is safe and effective, and it could be a treatment option for unresectable HCCs.Keywords: bevacizumab, hepatocellular carcinoma, microspheres, transarterial chemoembolization
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spelling doaj.art-b6a681c9be3746e0b04df4f935dc1ade2022-12-22T04:04:36ZengDove Medical PressJournal of Hepatocellular Carcinoma2253-59692022-09-01Volume 997398578154Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular CarcinomaUeda SHori SHori AMakitani KWan KSonomura TShota Ueda,1 Shinichi Hori,2 Atsushi Hori,2 Kazuhiro Makitani,2 Ke Wan,3 Tetsuo Sonomura1 1Department of Radiology, Wakayama Medical University, Wakayama, Japan; 2Department of Radiology, Institute for Image Guided Therapy, Izumisano City, Osaka, Japan; 3Clinical Study Support Center, Wakayama Medical University Hospital, Wakayama, JapanCorrespondence: Shota Ueda, Department of Radiology, Wakayama Medical University, 811-1, Kimiidera, Wakayama, Japan, Tel/Fax +81-73-441-0605, Email uedaaa@wakayama-med.ac.jpPurpose: To evaluate the efficacy and safety of chemoembolization with drug-eluting microspheres (DEM-TACE) combined with intra-arterial infusion of bevacizumab in patients with unresectable hepatocellular carcinoma (uHCC) and to identify possible prognostic factors.Patients and Methods: Between November 2014 and December 2020, 34 patients underwent DEM-TACE combined with intra-arterial infusion of bevacizumab for Barcelona Clinic Liver Cancer (BCLC) stage B hepatocellular carcinoma (HCC) beyond the Up-to-seven criteria or BCLC stage C HCC. Patients with extrahepatic metastasis or inferior vena cava invasion were excluded. The primary endpoint was overall survival (OS). The secondary endpoints were safety (assessed using Common Terminology Criteria for Adverse Events v5.0), the response rate at 1 month, and the identification of prognostic factors. The median OS was calculated using the Kaplan–Meier method. The response rate was evaluated according to the modified Response Evaluation Criteria in Solid Tumors. Prognostic factors were investigated by univariate and multivariable analysis using the Cox proportional hazards model.Results: The median OS was 13 months. BCLC stage and presence of portal vein invasion were not significantly associated with OS. There were no grade ≥ 3 adverse events. The Child–Pugh class did not decline after treatment in 31 of 34 patients. The overall response rate was 14.2% and the disease control rate was 100%. Significant prognostic factors were alcoholic liver disease, Child–Pugh score of ≥ 8, and microsphere size of 50– 100 μm.Conclusion: DEM-TACE combined with intra-arterial infusion of bevacizumab is safe and effective, and it could be a treatment option for unresectable HCCs.Keywords: bevacizumab, hepatocellular carcinoma, microspheres, transarterial chemoembolizationhttps://www.dovepress.com/retrospective-study-of-the-efficacy-and-safety-of-chemoembolization-wi-peer-reviewed-fulltext-article-JHCbevacizumabhepatocellular carcinomamicrospherestransarterial chemoembolization
spellingShingle Ueda S
Hori S
Hori A
Makitani K
Wan K
Sonomura T
Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
Journal of Hepatocellular Carcinoma
bevacizumab
hepatocellular carcinoma
microspheres
transarterial chemoembolization
title Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
title_full Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
title_fullStr Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
title_full_unstemmed Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
title_short Retrospective Study of the Efficacy and Safety of Chemoembolization with Drug-Eluting Microspheres Combined with Intra-Arterial Infusion of Bevacizumab for Unresectable Hepatocellular Carcinoma
title_sort retrospective study of the efficacy and safety of chemoembolization with drug eluting microspheres combined with intra arterial infusion of bevacizumab for unresectable hepatocellular carcinoma
topic bevacizumab
hepatocellular carcinoma
microspheres
transarterial chemoembolization
url https://www.dovepress.com/retrospective-study-of-the-efficacy-and-safety-of-chemoembolization-wi-peer-reviewed-fulltext-article-JHC
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