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31.08.2018 | Interventional

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

verfasst von: Roberto Iezzi, Maurizio Pompili, Emanuele Rinninella, Eleonora Annicchiarico, Matteo Garcovich, Lucia Cerrito, Francesca Ponziani, AnnaMaria De Gaetano, Massimo Siciliano, Michele Basso, Maria Assunta Zocco, GianLodovico Rapaccini, Alessandro Posa, Francesca Carchesio, Marco Biolato, Felice Giuliante, Antonio Gasbarrini, Riccardo Manfredi, the HepatoCatt Study Group

Erschienen in: European Radiology | Ausgabe 3/2019

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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

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Titel: TACE with degradable starch microspheres (DSM-TACE) as second-line treatment in HCC patients dismissing or ineligible for sorafenib
verfasst von: Roberto Iezzi
Maurizio Pompili
Emanuele Rinninella
Eleonora Annicchiarico
Matteo Garcovich
Lucia Cerrito
Francesca Ponziani
AnnaMaria De Gaetano
Massimo Siciliano
Michele Basso
Maria Assunta Zocco
GianLodovico Rapaccini
Alessandro Posa
Francesca Carchesio
Marco Biolato
Felice Giuliante
Antonio Gasbarrini
Riccardo Manfredi
the HepatoCatt Study Group
Publikationsdatum: 31.08.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 3/2019
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-018-5692-8

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Springer Medizin

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

Abstract

Objectives

Methods

Results

Conclusions

Key Points

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Abstract

Objectives

Methods

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Conclusions

Key Points

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