Title:Transarterial Chemoembolization Followed by Hepatic Arterial Infusion
Chemotherapy Combined a Tyrosine Kinase Inhibitor for Treatment of
Large Hepatocellular Carcinoma
Volume: 23
Issue: 7
Author(s): Bin Chen, Haitao Dai, Jianyong Yang, Guiyuan Zhang, Chunyong Wen, Xianhong Xiang, Run Lin*Yonghui Huang*
Affiliation:
- Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, China.
- Department of Interventional Radiology, the First Affiliated Hospital, Sun Yat-Sen University, 58 Zhongshan Road 2nd, Guangzhou 510080, China.
Keywords:
Hepatocellular carcinoma, transarterial chemoembolization, hepatic arterial infusion chemotherapy, tyrosine kinase inhibitor, triple-therapy, unresectable.
Abstract:
Objective: Evaluate the efficacy and safety of transarterial chemoembolization (TACE)
sequential with hepatic arterial infusion chemotherapy (HAIC) and a tyrosine kinase inhibitor (TKI)
for unresectable large hepatocellular carcinoma (HCC).
Methods: Patients with HCC size > 70 mm were included. They received 1-3 cycles of TACE and
sequential HAIC every 3-6 weeks for 2-6 cycles, with each cycle given over a period of 48 hours
(oxaliplatin plus fluorouracil/leucovorin). Patients also received sorafenib or lenvatinib beginning at
the first TACE cycle and continuing until disease progression. Objective response rate (ORR) at 3
months was the primary endpoint. Progression-free survival (PFS) and safety were the secondary
endpoints.
Results: From January 2020 to December 2020, 41 patients were included, who were divided into
the drug-eluting bead TACE (DEB-TACE) group (n=13) and conventional TACE (cTACE) group
(n=28). The overall ORR was 56.1% (23/41) using mRECIST criteria and 34.1% (14/41) using RECIST1.1
criteria. The median PFS of the cohort was 8 months. The ORR of the DEB-TACE group
was 76.9% (10/13) vs. 46.4% (13/28) for the cTACE group (p = 0.06). The median PFS of the DEBTACE
group was 12 months, and 6 months in the cTACE group (p = 0.09). Conversion hepatectomy
was performed in 2 patients in the DEB-TACE group (15.4%), and in 3 patients in the cTACE
group (10.7%). ALT/AST elevated, hypertension, nausea, and vomiting were the common treatment
related adverse events. There was no treatment related death.
Conclusion: TACE sequential with HAIC combined a TKI is a well-tolerated and promising tripletherapy
for large, unresectable HCC.
