Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma
Abstract
Simple Summary
Abstract
1. Introduction
Hepatocellular Carcinoma
2. Staging in Hepatocellular Carcinoma
3. Patient Selection for TACE Therapy
4. TACE Technique
5. TACE Outcomes
5.1. Outcomes for TACE in Early-Stage HCC
5.2. Outcomes for TACE in Intermediate-Stage HCC
5.3. Outcomes for TACE in Advanced HCC
6. Future Directions
7. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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BCLC Classification | Stage | Definition | BCLC Treatment Guideline |
---|---|---|---|
0 | Single nodule | ||
Very early stage | ≤2 cm | Resection or liver transplant | |
PS = 0 | |||
A | Early stage | Single or ≤3 nodules | Resection or liver transplant |
Each nodule ≤ 3 cm | |||
B | Multinodular | TACE | |
Intermediate stage | Preserved liver function PS = 0 | ||
C | Portal invasion and/or extrahepatic spread | Systemic treatment | |
Advanced stage | Preserved liver function PS = 1–2 | ||
D | Any tumor burden | Best supportive care | |
Terminal stage | End-stage liver function PS = 3–4 |
Stage of HCC | Study | TACE Method | Overall Survival | Progression-Free Survival | Adverse Events |
---|---|---|---|---|---|
Early (BCLC 0-A) | Bargellini et al. [37] | Selective | 1 year: 90.9% 2 years: 86.1% 3 years: 80.5% | Disease progression observed in 17.9% of patients, with a mean expected time of 26.5 months | Increased ALT and bilirubin 58.2% PES |
GIDEON [38] | Concomitant TACE and sorafenib | Median OS: 21.4 months | Not reported | No unexpected toxicity | |
Chen et al. [39] | Adjuvant TACE following HCC resection | 1 year: 28–82% 3 years: 32–43.9% | Not reported | Not reported | |
Intermediate (BCLC B) | Burrel et al. [40] | DEB-TACE | 1 year: 88.2% 3 years: 64.4% 4 years: 47.4% 5 years: 39.4% | Not reported | Not reported |
GIDEON [38] | Concomitant TACE and sorafenib | Median OS: 27 months | Not reported | No unexpected toxicity | |
SPACE [41] | DEB-TACE +/− sorafenib | Not reported | Median TTP: 169 days | Safe and feasible | |
TACTICS [42] | TACE +/− sorafenib | Not reported | PFS: 25.2 months TTP: 24.1 months | No unexpected toxicity | |
Advanced (BCLC C) | GIDEON [38] | Concomitant TACE and sorafenib | Median OS: 15.5 months | Not reported | Not reported |
Zhang et al. [43] | TACE + sorafenib vs. TACE alone | TACE + sorafenib improved OS: HR = 0.65 | TACE + sorafenib improved TTP: HR = 0.68 | Increased incidence of grade III/IV adverse reactions compared to TACE alone |
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Fite, E.L.; Makary, M.S. Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma. Cancers 2024, 16, 2430. https://doi.org/10.3390/cancers16132430
Fite EL, Makary MS. Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma. Cancers. 2024; 16(13):2430. https://doi.org/10.3390/cancers16132430
Chicago/Turabian StyleFite, Elliott L., and Mina S. Makary. 2024. "Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma" Cancers 16, no. 13: 2430. https://doi.org/10.3390/cancers16132430
APA StyleFite, E. L., & Makary, M. S. (2024). Transarterial Chemoembolization Treatment Paradigms for Hepatocellular Carcinoma. Cancers, 16(13), 2430. https://doi.org/10.3390/cancers16132430