scholarly journals Hepatic Arterial Infusion Chemotherapy Is a Feasible Treatment Option for Hepatocellular Carcinoma: A New Update

2021 ◽  
pp. 1-8
Author(s):  
Maher Hendi ◽  
Yiping Mou ◽  
Jiemin Lv ◽  
Bin Zhang ◽  
Xiujun Cai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Trials ◽  
Randomized Clinical Trials ◽  
Hepatic Arterial Infusion ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Hepatic Artery Infusion ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Advanced Hcc ◽  
Infusion Chemotherapy

<b><i>Background:</i></b> Hepatic arterial infusion chemotherapy (HAIC) is one option for treating massive tumors and unresectable hepatocellular carcinoma (HCC). However, there is a lack of remedial treatment after these treatments are ineffective or failed. <b><i>Summary:</i></b> Some studies have discovered that HAIC has greater survival in patients with advanced HCC. A previous study has shown that HAIC is effective in the treatment of advanced HCC, and the data on randomized clinical trials are limited and unclear. <b><i>Key Message:</i></b> More clinical trials and research are needed in order to make HAIC a standard and recommended therapy for advanced HCC. Our review focuses on the clinical applications of hepatic artery infusion treatment.

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma by placing a temporary catheter via the subclavian route

2007 ◽  
Vol 48 (7) ◽  
pp. 734-740 ◽  
Author(s):  
Huei-Lung Liang ◽  
Jer-Shyung Huang ◽  
Yi-Huei Lin ◽  
Kwok-Hung Lai ◽  
Chien-Fang Yang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Response Rate ◽  
Hepatic Arterial Infusion ◽  
Catheter Placement ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Advanced Hcc ◽  
Infusion Chemotherapy

Background: A permanent reservoir implantation is considered mandatory for hepatic arterial infusion chemotherapy (HAIC) of hepatocellular carcinoma (HCC). Since treatment sessions of HAIC may be limited for these end-staged patients, a simple alternative technique for this treatment is desirable. Purpose: To evaluate the feasibility of placing a temporary catheter for HAIC in advanced HCC patients. Material and Methods: 25 advanced HCC patients underwent HAIC with drugs delivered from a temporary catheter which was placed percutaneously by puncturing the left subclavian artery under ultrasound guidance. A course of chemotherapy consisted of five consecutive daily infusions of 5-fluorouracil, cisplatin, mitomycin C, and leucovorin. The catheter was removed on the 6th day. Therapy was repeated every 4–6 weeks with maximal number of courses of up to six. The total courses of HAIC in each patient, the catheter-placed-related complications, tumor response rate, and median survival of the patients were registered. Results: A total of 77 courses of HAIC were performed with 100% technical success of catheter placement (1–6 courses in each patient, average 3.1 courses). The overall response rate was 20%, with complete response in two patients and partial response in three patients. Eleven (55%) of the 20 non-responders died within 5 months (mean HAIC, two courses). None of the patients experienced complications such as catheter occlusion, hepatic arterial thrombosis, cerebral infarction, or local infection. Conclusion: With fewer catheter-related complications, HAIC by temporary catheter placement via subclavian puncture could be a treatment option.

scholarly journals Hepatic Arterial Infusion Chemotherapy versus Sorafenib in Patients with Advanced Hepatocellular Carcinoma

Liver Cancer ◽  
2020 ◽  
Vol 9 (5) ◽  
pp. 583-595
Author(s):  
Kazuomi Ueshima ◽  
Sadahisa Ogasawara ◽  
Masafumi Ikeda ◽  
Yutaka Yasui ◽  
Takeshi Terashima ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Hepatic Arterial Infusion ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Advanced Hcc ◽  
Infusion Chemotherapy

Background: Prior to the approval of sorafenib, hepatic arterial infusion chemotherapy (HAIC) was offered to patients with advanced hepatocellular carcinoma (HCC) in East Asia, particularly Japan. According to the Japanese guidelines, HAIC is recommended as one of the treatment options in patients without extrahepatic metastasis (EHM). Methods: The present cohort study compared the use of HAIC and sorafenib on outcomes of patients with advanced HCC. Consecutive patients with advanced HCC who received HAIC or sorafenib as a first-line systemic therapy were enrolled from 10 Japanese institutions. The primary outcomes were overall survival (OS) in patients with macrovascular invasion (MVI), but without EHM, and OS in patients without both MVI and EHM. Results: Between 2009 and 2016, 2,006 patients were enrolled (541 HAIC patients, 1,465 sorafenib patients). After propensity score matching, the OS of patients with MVI but without EHM was significantly longer in the HAIC group compared with the sorafenib group (10.1 vs. 9.1 months for the HAIC and sorafenib groups, respectively; n = 170 for each group; hazard ratio [HR] 0.668; 95% confidence interval [95% CI] 0.475–0.935; p = 0.018). There was no significant difference in OS between patients without both MVI and EHM (12.2 vs. 15.4 months for the HAIC and sorafenib groups, respectively; n = 76 in each cohort after propensity score matching; HR 1.227; 95% CI 0.699–2.155; p = 0.475). Conclusion: HAIC is a potential front-line treatment choice in a subpopulation of patients with advanced HCC with MVI but without EHM.

scholarly journals Hepatic Arterial Infusion Chemotherapy with Cisplatin Versus Sorafenib for Intrahepatic Advanced Hepatocellular Carcinoma: A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Yuki Zaizen ◽  
Masahito Nakano ◽  
Kazuta Fukumori ◽  
Yoichi Yano ◽  
Kota Takaki ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Propensity Score ◽  
Hepatic Arterial Infusion ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Significant Difference

Given that the outcome of hepatic arterial infusion chemotherapy (HAIC) with cisplatin for intrahepatic advanced hepatocellular carcinoma (HCC) is unclear, we aimed to compare prognostic factors for overall survival (OS) following HAIC with cisplatin versus sorafenib for intrahepatic advanced HCC using propensity score-matched analysis. We enrolled 348 patients with intrahepatic advanced HCC who received HAIC with cisplatin (n = 97) or sorafenib (n = 251) between June 2006 and March 2020. No significant difference was observed in OS between HAIC with cisplatin and sorafenib cohorts (median survival time [MST]: 13.9 vs. 12.7 months; p = 0.0989). To reduce confounding effects, 176 patients were selected using propensity score-matched analysis (n = 88 for each treatment). HAIC with cisplatin significantly prolonged OS compared with sorafenib (MST: 16.2 vs. 12.2 months; p = 0.0060). Following stratification according to the Child–Pugh classification, for both patients with class A (MST: 24.0 vs. 15.6 months; p = 0.0097) and class B (MST: 8.5 vs. 6.9 months; p = 0.0391), HAIC with cisplatin rather than sorafenib significantly prolonged OS. Our findings suggest that HAIC with cisplatin demonstrates longer prognostic effects than sorafenib in intrahepatic advanced HCC, regardless of the hepatic reserve.

Hepatic arterial infusion chemotherapy versus Sorafenib for advanced hepatocellular carcinoma with portal vein tumor thrombus: a systematic review and meta-analysis

2020 ◽  
Author(s):  
guoqing ouyang ◽  
Guangdong Pan ◽  
Qiang Liu ◽  
Yongrong Wu ◽  
shengqiang Tan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Response Rate ◽  
Meta Analysis ◽  
Hepatic Arterial Infusion ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Cochrane Library ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Advanced Hcc ◽  
Infusion Chemotherapy

Abstract Background : Hepatocellular carcinoma (HCC) is ranked as the sixth most common solid cancer and the third leading cause of cancer-related death in the world. Sorafenib is the first line systematic treatment for patients with advanced HCC. Hepatic arterial infusion chemotherapy（HAIC）has been proved to be an effective treatment for advanced HCC. Here, we conducted a meta-analysis to compared the efficacy of HAIC versus sorafenib of advanced HCC patients with PVTT. Methods : The databases of MEDLINE (PubMed), Cochrane Library, EMBASE, and Web of Science were systematically searched for retrieving the relevant publications before 31 July 2019. The endpoint included overall survival (OS), time to progression (TTP), partial response rate (PRR), complete response rate (CRR), objective response rate (ORR), stable disease rate (SDR). Results : A total of three studies involving 214 advanced HCC patients with PVTT enrolled in this meta-analysis. HAIC significantly improved TTP (hazard ratio (HR) = 0.56, 95% CI: 0.39-0.82; P = 0.003), PRR (odds ratio (OR) = 3.31, 95% CI: 1.46-7.50; P = 0.004), ORR (OR = 3.78, 95% CI: 1.68-8.50; P = 0.001) compared to sorafenib. However, no significant difference was found in OS (HR=0.77, 95%CI: 0.56-1.06, p=0.11), CRR (OR = 2.54, 95% CI: 0.39-16.47; P = 0.33), SDR (OR = 1.48, 95% CI: 0.43-5.08; P = 0.001). Conclusions : This meta-analysis suggested that HAIC provides better TTP, PRR, ORR than sorafenib for patients of advanced HCC with PVTT. Therefore, we recommend HAIC as a potential therapy for advanced HCC patients with PVTT. However, owing to the above limitations, more high-quality studies are warranted to evaluate this finding.

scholarly journals Clinical Benefits of Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma

2021 ◽  
Vol 11 (4) ◽  
pp. 1882
Author(s):  
Takahiro Yamasaki ◽  
Issei Saeki ◽  
Yurika Kotoh-Yamauchi ◽  
Ryo Sasaki ◽  
Norikazu Tanabe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Vascular Invasion ◽  
Hepatic Arterial Infusion ◽  
Hepatic Arterial Infusion Chemotherapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Arterial Infusion ◽  
Arterial Infusion Chemotherapy ◽  
Infusion Chemotherapy ◽  
Recent Success ◽  
Clinical Benefits

Recent success of systemic therapeutic agents, including combination immunotherapy, could promote a change in the treatment strategy in patients with advanced hepatocellular carcinoma (HCC). Although hepatic arterial infusion chemotherapy (HAIC) is a treatment option for advanced HCC in Japan, it is not recommended by other guidelines. We discuss the clinical benefits of HAIC compared to sorafenib. The clinical benefits of HAIC are as follows: (1) even a patient with Child–Pugh B HCC (7 or 8 points) is a candidate for HAIC (2) Child–Pugh scores barely decline with the use of HAIC compared with sorafenib (3) HAIC is highly effective in patients with vascular invasion compared with sorafenib; and (4) survival in patients receiving HAIC may not be associated with skeletal muscle volume. In contrast, the disadvantages are problems related with the reservoir system. HAIC has clinical benefits in a subpopulation of patients without extrahepatic metastasis with Child–Pugh A HCC and vascular invasion (especially primary branch invasion or main portal vein invasion) or with Child–Pugh B HCC.

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