Erschienen in:
08.07.2016 | Clinical Investigation
Pharmacokinetics, Safety, and Efficacy of Chemoembolization with Doxorubicin-Loaded Tightly Calibrated Small Microspheres in Patients with Hepatocellular Carcinoma
verfasst von:
Katerina Malagari, Theodoros Kiakidis, Maria Pomoni, Hippokratis Moschouris, Emmanouil Emmanouil, Themis Spiridopoulos, Vlasios Sotirchos, Savvas Tandeles, Dimitrios Koundouras, Alexios Kelekis, Dimitrios Filippiadis, Angelos Charokopakis, Evanthia Bouma, Achilles Chatziioannou, Spyridon Dourakis, John Koskinas, Theodoros Karampelas, Konstantinos Tamvakopoulos, Nikolaos Kelekis, Dimitrios Kelekis
Erschienen in:
CardioVascular and Interventional Radiology
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Ausgabe 10/2016
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Abstract
Purpose
This study examines safety, efficacy, and pharmacokinetics of chemoembolization with loadable microspheres ≤100 μm for hepatocellular carcinoma.
Materials and Methods
A pilot safety study was performed in 19 patients with size and dose escalation and then 52 patients were enrolled prospectively and randomly assigned to chemoembolization with TANDEM™ loaded with 150 or 100 mg of doxorubicin.
Results
The mean diameter of the tumors was 7.28 ± 2.09 cm (range 4–12) and distribution dominant/multiple 51.9/48.1 %. Child A/B distribution was 32/20 (61.5/38.5 %) and etiology HBV/HCV/HBV/HCV-hemochromatosis was 61.6/9.6/9.6/15.4 %. Twenty-five patients were assigned in the low and 27 in the high loading group. There was 1.92 % thirty-day mortality due to lesion rupture. Biliary damage was seen in 3 patients (5.7 %) in the high loading. Mean maximum plasma concentration of doxorubicin C
max ± SD was 284.9 ± 276.2 ng/mL for the high and 108.5 ± 77.6 ng/mL for the low loading (p < 0.001). According to m-RECIST overall objective response after two sessions reached 61.22 and 63.82 % at 6 months. Notably, complete target lesion response (CR) after the second session was observed in 28.57 % and maintained in 23.40 % at 6 months. No statistical differences in the local response rates were observed between the two loading groups. Overall survival (OS) at 6 months, 1 , 2, and 3 years was 98.08, 92.3, 88.46, and 82.6 %, respectively. OS and Progression-Free Survival did not demonstrate statistical significance between the two loading groups.
Conclusion
Initial evidence shows that (a) TANDEM™ achieves high rates of local response and mid-term survival, (b) high loading provides no clinical benefit and is associated with biliary toxicity.