scholarly journals Effects of Antiviral Therapy on HBV Reactivation and Survival in Hepatocellular Carcinoma Patients Undergoing Hepatic Artery Infusion Chemotherapy

2021 ◽  
Vol 10 ◽  
Author(s):  
Shousheng Liu ◽  
Jinfa Lai ◽  
Ning Lyu ◽  
Qiankun Xie ◽  
Huijiao Cao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Hepatic Artery ◽  
Primary Hepatocellular Carcinoma ◽  
Hepatic Artery Infusion ◽  
Hbv Reactivation ◽  
Antiviral Prophylaxis ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

BackgroundThis study aimed to investigate the influence of hepatic artery infusion chemotherapy (HAIC) on hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg) positive patients with primary hepatocellular carcinoma (HCC) as well as evaluate the role of antiviral prophylaxis in these patients.MethodsWe enrolled 170 HBsAg-positive advanced HCC patients receiving HAIC using mFOLFOX regimen, of which 137 patients received antiviral prophylaxis. Risk factors for HBV reactivation were analyzed. The overall survival (OS) from the first application of HAIC were compared between antiviral and non-antiviral groups.ResultsA total of 25 patients (14.7%) developed HBV reactivation after HAIC, of which 16 patients received antiviral treatment and nine patients did not. The incidence of HBV reactivation was 11.7% (16/137) in antiviral group and 27.3% (9/33) in non-antiviral group respectively. No antiviral prophylactic was the only significant risk factor for HBV reactivation (OR=12.35, 95% confidence interval (CI) 4.35–33.33, p<0.001). Patients in antiviral group received more cycles of HAIC compared with non-antiviral group (3.11 ± 1.69 vs 1.75 ± 1.18, p<0.05) at the time of HBV reactivated. Seven of the 25 HBV reactivation patients developed hepatitis. OS in antiviral group was significantly longer than that of non-antiviral group (median 16.46 vs 10.68 months; HR=0.57; 95% CI, 0.36–0.91; p<0.05).ConclusionsHBV reactivation is more prone to occur in the HBsAg-positive HCC patients undergoing HAIC without antiviral prophylaxis. Regular monitoring of HBV DNA and antiviral prophylaxis are suggested to prevent HBV reactivation as well as prolong the OS of these patients.Name of the Trial RegisterHAIC Using Oxaliplatin Plus Fluorouracil/Leucovorin for Patients with Locally Advanced HCC.Clinical Trial Registrationhttps://www.clinicaltrials.gov/, identifier NCT 02436044

scholarly journals Hepatic Arterial Infusion Chemotherapy Combined With PD-1 Inhibitors Plus Lenvatinib Versus PD-1 Inhibitors Plus Lenvatinib for Advanced Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Jie Mei ◽  
Yu-Hao Tang ◽  
Wei Wei ◽  
Ming Shi ◽  
Lie Zheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Arterial Infusion ◽  
Progression Free Survival ◽  
Good Survival ◽  
Hepatic Artery Infusion ◽  
Advanced Hepatocellular Carcinoma ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy ◽  
Cell Death Protein

BackgroundLenvatinib combined with programmed cell death protein-1 (PD-1) inhibitors has resulted in good survival outcomes in the treatment of unresectable hepatocellular carcinoma (HCC). Hepatic artery infusion chemotherapy (HAIC) has also attracted attention due to its high response rates and favorable survival for advanced HCC patients. The present study aimed to compare the efficacy of HAIC combined with PD-1 inhibitors plus lenvatinib (HPL) and PD-1 inhibitors plus lenvatinib (PL) in patients with advanced HCC.MethodsBetween July 2018 and December 2019, patients diagnosed with advanced HCC who initially received HPL or PL treatment were reviewed for eligibility. Efficacy was evaluated according to tumor response and survival.ResultsIn total, 70 patients met the criteria and were included in the present study, and they were divided into the HPL group (n = 45) and PL group (n = 25). The overall response rate (40.0 vs. 16.0%, respectively; p = 0.038) and disease control rate (77.6 vs. 44.0%, respectively; p < 0.001) were higher in the HPL group than in the PL group. The median overall survival was 15.9 months in the HPL group and 8.6 months in the PL group (p = 0.0015; HR = 0.6; 95% CI 0.43–0.83). The median progression-free survival was 8.8 months in the HPL group and 5.4 months in the PL group (p = 0.0320; HR = 0.74; 95% CI 0.55–0.98).ConclusionCompared to PL, HPL was associated with a significantly better treatment response and survival benefits for patients with advanced HCC.

scholarly journals Hepatic artery-infusion chemotherapy improved survival of hepatocellular carcinoma after radical hepatectomy

2017 ◽  
Vol Volume 10 ◽  
pp. 3001-3005 ◽  
Author(s):  
Min Feng ◽  
Chengwu Tang ◽  
Wenming Feng ◽  
Ying Bao ◽  
Yinyuan Zheng ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Hepatic Artery Infusion ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

scholarly journals Real-world study of hepatic artery infusion chemotherapy combined with anti-PD-1 immunotherapy and tyrosine kinase inhibitors for advanced hepatocellular carcinoma

Immunotherapy ◽  
2021 ◽  
Author(s):  
Bao-Jiang Liu ◽  
Song Gao ◽  
Xu Zhu ◽  
Jian-Hai Guo ◽  
Fu-Xin Kou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Tyrosine Kinase ◽  
Kinase Inhibitors ◽  
Progression Free Survival ◽  
Hepatic Artery Infusion ◽  
Advanced Hepatocellular Carcinoma ◽  
Free Survival ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

Aim: We investigated the efficacy and safety of hepatic artery infusion chemotherapy (HAIC) combined with anti-PD-1 immunotherapy and tyrosine kinase inhibitors (TKIs) for advanced hepatocellular carcinoma (HCC). Method: This retrospective study included HCC patients treated with HAIC, TKIs and anti-PD-1 antibodies between May 2019 and November 2020 in our hospital. Primary end points were progression-free survival and safety. Results: Twenty-seven advanced HCC patients were analyzed. The median follow-up was 12.9 months (range: 4.0–24.0 months) and the median progression-free survival was 10.6 months. The objective response rate and disease control rate were 63.0 and 92.6%, respectively. No treatment-related deaths occurred. Conclusion: In patients with advanced HCC, treatment with HAIC, anti-PD-1 antibodies and oral TKIs was effective and safe.

scholarly journals Determinants of pain in advanced HCC patients recieving hepatic artery infusion chemotherapy

2020 ◽  
Author(s):  
Zhiqiang Wu ◽  
Wenbo Guo ◽  
Song Chen ◽  
Wenquan Zhuang
Keyword(s):  
Hepatic Artery ◽  
Linear Regression Analysis ◽  
Hepatic Artery Infusion ◽  
Multivariate Linear Regression Analysis ◽  
Preparation Time ◽  
Advanced Hcc ◽  
Infusion Chemotherapy ◽  
Vas Score ◽  
Hepatic Artery Infusion Chemotherapy ◽  
Lidocaine Injection

Summary Purpose Hepatic arterial infusion chemotherapy (HAIC) is one of the options to treat unresectable hepatocellular carcinoma (HCC). The majority of HCC patients suffer great pain in the course of HAIC treatment. To improve the quality of life and the efficacy of HAIC treatment, the causes of pain, the choice of an analgesic regimen, and the relationship between pain and prognosis of HCC were analyzed. Methods A total of 376 HCC patients under HAIC in our hospital were recriuted between March 2017 and September 2019. Multivariate linear regression analysis (stepwise) was used to calculate the potential factors related to the severe pain in HCC patients under HAIC. Analgesics treatments were carried out based on the results of the visual analogue scale (VAS) score which was used to evaluate the pain. Results The mean value of the VAS score is 3.604, which indicates that the pain in most patients is mild and endurable. Intra-arterial lidocaine injection is an effective method in most patients (96%, 361 of 376), and the total score of VAS is reduced from 1355 to 195 following lidocaine injection. Multivariate analysis suggestes that oxaliplatin (OXA) preparation time, hepatic artery diameter and OXA manufacturers (R2 = 0.859) are influential factors for pain scores. Conclusion This study demonstrates an effective way to systematically assess and ease pain in HCC patients with HAIC treatment. OXA preparation time, hepatic artery diameter, and OXA manufacturers are the potential influencing factors for pain. This work presented here will provide a detailed understanding of the clinical application of HAIC in advanced HCC patients.

scholarly journals Meta-Analysis of Postoperative Adjuvant Hepatic Artery Infusion Chemotherapy Versus Surgical Resection Alone for Hepatocellular Carcinoma

2021 ◽  
Vol 11 ◽  
Author(s):  
Qiao Ke ◽  
Lei Wang ◽  
Weimin Wu ◽  
Xinhui Huang ◽  
Ling Li ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Surgical Resection ◽  
Meta Analysis ◽  
Disease Free Survival ◽  
Cochrane Library ◽  
Hepatic Artery Infusion ◽  
Infusion Chemotherapy ◽  
Hepatic Artery Infusion Chemotherapy

BackgroundTo systematically identify the long-term efficacy of postoperative adjuvant hepatic artery infusion chemotherapy (HAIC) for patients with hepatocellular carcinoma (HCC).MethodsPubMed, MedLine, Embase, the Cochrane Library, and Web of Science were searched to collect the eligible studies up to March 31, 2021, that compared the surgical resection (SR) versus SR+HAIC for HCC patients. The endpoints were overall survival (OS) rates and disease-free survival (DFS) rates, and the effect size was determined by hazard ratio (HR) with 95% CI.ResultsA total of 12 studies (two randomized controlled trials (RCTs) and 10 non-RCTs) including 1,333 patients were eligible for this meta-analysis. The pooled results showed that OS and DFS rates in the SR+HAIC group were both better than those in the SR alone group (HR = 0.56, 95% CI = 0.41–0.77, p < 0.001; HR = 0.66, 95% CI = 0.55–0.78, p < 0.001, respectively). Furthermore, the subgroup analysis showed that patients would benefit from SR+HAIC regardless of chemotherapy regimens and courses (all p < 0.05), and patients with microvascular or macrovascular invasion would also benefit more from SR+HAIC in terms of OS and DFS (all p < 0.05).ConclusionPostoperative adjuvant HAIC could improve the long-term prognosis of HCC patients, especially for those with microvascular or macrovascular invasion, regardless of chemotherapy regimens and courses, but it deserves further validation.

scholarly journals Revisiting Hepatic Artery Infusion Chemotherapy in the Treatment of Advanced Hepatocellular Carcinoma

2021 ◽  
Vol 22 (23) ◽  
pp. 12880
Author(s):  
Ching-Tso Chen ◽  
Tsung-Hao Liu ◽  
Yu-Yun Shao ◽  
Kao-Lang Liu ◽  
Po-Chin Liang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatic Artery ◽  
Treatment Efficacy ◽  
Tumor Burden ◽  
Hepatic Artery Infusion ◽  
Advanced Hepatocellular Carcinoma ◽  
Clinical Value ◽  
Infusion Chemotherapy ◽  
Vein Thrombosis ◽  
Hepatic Artery Infusion Chemotherapy

Hepatic artery infusion chemotherapy (HAIC) is a well-established and common treatment for advanced hepatocellular carcinoma (HCC), particularly in East Asia. However, HAIC is not recognized internationally. Although several trials have demonstrated the safety and efficacy of HAIC, evidence corroborating its overall survival (OS) benefits compared with standard treatments is insufficient. Nevertheless, HAIC may provide prominent benefits in selected patients such as patients with portal vein thrombosis or high intrahepatic tumor burden. Moreover, HAIC has been combined with several therapeutic agents and modalities, including interferon-alpha, multikinase inhibitors, radiation therapy, and immunotherapy, to augment its treatment efficacy. Most of these combinations appeared to increase overall response rates compared with HAIC alone, but results regarding OS are inconclusive. Two prospective randomized controlled trials comparing HAIC plus sorafenib with sorafenib alone have reported conflicting results, necessitating further research. As immunotherapy-based combinations became the mainstream treatments for advanced HCC, HAIC plus immunotherapy-based treatments also showed encouraging preliminary results. The trials of HAIC were heterogeneous in terms of patient selection, chemotherapy regimens and doses, HAIC combination agent selections, and HAIC technical protocols. These heterogeneities may contribute to differences in treatment efficacy, thus increasing the difficulty of interpreting trial results. We propose that future trials of HAIC standardize these key factors to reveal the clinical value of HAIC-based treatments for HCC.

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