Bi-monthly hepatic arterial infusion chemotherapy as a novel strategy for advanced hepatocellular carcinoma in decompensated cirrhotic patients
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background/Aims: We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis. Methods: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed. Results: Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child- Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group. Conclusions: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.
Abstract
Background/Aims: We previously reported the comparable efficacy of bi-monthly hepatic arterial infusion chemotherapy (B-HAIC) to that of sorafenib chemotherapy for the treatment of advanced hepatocellular carcinoma (aHCC) in patients with compensated cirrhosis. In this study, we demonstrate the efficacy of B-HAIC in patients with decompensated cirrhosis. Methods: Forty-five patients with aHCC refractory to transcatheter arterial chemo-embolization (TACE) were treated with B-HAIC and were divided into two groups according to hepatic functional reserve (Child-Pugh grade). Overall survival period, treatment response, and adverse events in each group were analyzed. Results: Efficacy and disease control rates in the Child-Pugh B group (n=24; 21% and 71%, respectively) were not significantly impaired compared the Child-Pugh A group (n=21; 38% and 67%, respectively). Median survival time and survival rate at 12 months in the Child-Pugh B group were 422 days and 58.3%, respectively, whereas those in the Child- Pugh A group were 567 days and 70.8%, respectively. Importantly, the hepatic functional reserve of patients did not worsen in either group during the treatment period. Furthermore, the occurrence rate of adverse events leading to discontinuation of anti-tumor treatment was not significantly increased in the Child-Pugh B group. Conclusions: Given the preservation of hepatic functional reserve afforded by B-HAIC chemotherapy in patients with decompensated cirrhosis, B-HAIC might be an acceptable alternative strategy for aHCC patients who do not respond to TACE.
참고문헌 (39)
- "Cancer Today"[URL]
- Llovet JM, "Sorafenib in advanced hepatocellular carcinoma", N Engl J Med, 359, pp.378~390 (2008)
- Kudo M, "Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomized phase 3 non-inferiority trial", Lancet, 391, pp.1163~1173 (2018)
- Swift B, "Sorafenib hepatobiliary disposition: mechanism of hepatic uptake and disposition of generated metabolites", Drug Metab Dispos, 41, pp.1179~1186 (2013)
- Hussein Z, "Clinical pharmacokinetic and pharmacodynamic profile of lenvatinib, an orally active, small module, multitargeted tyrosine kinase inhibitor", Eur J Drug Metab Pharmacokinet, 42, pp.903~914 (2017)
- Kaneko S, "Guideline on the use of new anticancer drugs for the treatment of Hepatocellular Carcinoma 2010 update", Hepatol Res, 42, pp.523~542 (2012)
- Heimbach JK, "AASLD guidelines for the treatment of hepatocellular carcinoma", Hepatology, 67, pp.358~380 (2018)
- Song DS, "A comparative study between sorafenib and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma with portal vein tumor thrombosis", J Gastroenterol, 50, pp.445~454 (2015)
- 오명진, "Efficacy and safety of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma as firstline therapy", Clinical and Molecular Hepatology, 19(3), pp.288~299 (2013), 대한간학회[DOI]
- Niizeki T, "Serum vascular endothelial growth factor as a predictor of response and survival in patients with advanced hepatocellular carcinoma undergoing hepatic arterial infusion chemotherapy", J Gastroenterol, 47, pp.686~695 (2012)
- Miyaki D, "Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma according to Child-Pugh classification", J Gastroenterol Hepatol, 27, pp.1850~1857 (2012)
- Tsai WL, "Hepatic arterial infusion chemotherapy for patients with huge unresectable hepatocellular carcinoma", PLoS One, 9, pp.e92784~ (2014)
- Terashima T, "Feasibility and efficacy of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma after sorafenib", Hepatol Res, 44, pp.1179~1185 (2014)
- Shao YY, "A pilot study of hepatic arterial infusion of chemotherapy for patients with advanced hepatocellular carcinoma who have failed antiangiogenic therapy", Liver Int, 33, pp.1413~1419 (2013)
- Kudo M, "Management of hepatocellular carcinoma in Japan: Consensus-Based Clinical Practice Guidelines proposed by the Japan Society of Hepatology (JSH) 2010 updated version", Dig Dis, 29, pp.339~364 (2011)
- Kudo M, "JSH consensus-based clinical practice guideline for the management of hepatocellular carcinoma: 2014 update by the Liver Cancer Study Group of Japan", Liver Cancer, 3, pp.458~468 (2014)
- Lok AS, "Des-gamma-carboxy prothrombin and alpha-fetoprotein as biomarkers for the early detection of hepatocellular carcinoma", Gastroenterol, 138, pp.493~502 (2010)
- Park SJ, "Usefulness of AFP, AFP-L3, and PIVKA-II, and their combinations in diagnosing hepatocellular carcinoma", Medicine (Baltimore), 96, pp.e5811~ (2017)
- Lencioni R, "Modified RECIST (mRECIST) assessment for hepatocellular carcinoma", Semin Liver Dis, 30, pp.52~60 (2010)
- "Common Terminology Criteria for Adverse Events"[URL]
- "Ethical Guidelines for Medical and Health Research Involving Human Subjects"[URL]
- Lin DY, "Hepatic arterial embolization in patients with unresectable hepatocellular carcinoma--a randomized controlled trial", Gastroenterol, 94, pp.453~456 (1998)
- Groupe d’Etude et de Traitement du Carcinome Hépatocellulaire, "A comparison of lipiodol chemoembolization and conservative treatment for unresectable hepatocellular carcinoma", N Engl J Med, 332, pp.1256~1261 (1995)
- Lo CM, "Randomized controlled trial of transarterial lipiodol chemoembolization for unresectable hepatocellular carcinoma", Hepatology, 35, pp.1164~1171 (2002)
- Llovet JM, "Arterial embolization or chemoembolization versus symptomatic treatment in patients with unresectable hepatocellular carcinoma: a randomized controlled trial", Lancet, 359, pp.1734~1739 (2002)
- Cammà C, "Transarterial chemoembolization for unresectable hepatocellular carcinoma: meta-analysis of randomized controlled trials", Radiology, 224, pp.47~54 (2002)
- Llovet JM, "Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival", Hepatology, 37, pp.429~442 (2003)
- Lu W, "A comparative study of damage to liver function after TACE with use of low-dose versus conventional-dose of anticancer drugs in hepatocellular carcinoma", Hepatogastroenterology, 54, pp.1499~1502 (2007)
- Nishikawa H, "Branched-chain amino acid treatment before transcatheter arterial chemoembolization for hepatocellular carcinoma", World J Gastroenterol, 18, pp.1379~1384 (2012)
- Ishikawa T, "Concurrent partial splenic embolization with transcatheter arterial chemoembolization for hepatocellular carcinoma can maintain hepatic functional reserve", Hepatol Res, 44, pp.1056~1061 (2014)
- Pugh RN, "Transection of the oesophagus for bleeding oesophageal varices", Br J Surg, 60, pp.646~649 (1973)
- Montano-Loza AJ, "Clinical relevance of sarcopenia in patients with cirrhosis", World J Gastroenterol, 20, pp.8061~8071 (2014)
- Moriya K, "Efficacy of bi-monthly hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma", J Gastrointest Oncol, 4, pp.741~749 (2018)
- Iwasa S, "Transcatheter arterial infusion chemotherapy with a fine-powder formulation of cisplatin for advanced hepatocellular carcinoma refractory to transcatheter arterial chemoembolization", Jpn J Clin Oncol, 41, pp.770~775 (2011)
- Yoshikawa M, "Phase II study of hepatic arterial infusion of a fine-powder formulation of cisplatin for advanced hepatocellular carcinoma", Hepatol Res, 38, pp.474~483 (2008)
- Ikeda M, "Efficacy of sorafenib in patients with hepatocellular carcinoma refractory to trasncatheter arterial chemoembolization", J Gastroenterol, 49, pp.932~940 (2014)
- Hatooka M, "Comparison of outcome of hepatic arterial infusion chemotherapy and sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization", Anticancer Res, 36, pp.3523~3529 (2016)
- Kawaoka T, "Comparison of hepatic arterial infusion chemotherapy versus sorafenib monotherapy in patients with advanced hepatocellular carcinoma", J Dig Dis, 16, pp.505~512 (2015)
- Fukubayashi K, "Evaluation of sorafenib treatment and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma: a comparative study using the propensity score matching method", Cancer Med, 4, pp.1214~1223 (2015)