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Liang Y, Xie Y, Liu X, Yu L, Yan H, Shang Z, Wu Y, Cai X, Shi W, Du J, Yang Z. Integrating Network Pharmacology and Experimental Validation to Decipher the Mechanism of Action of Astragalus- Atractylodes Herb Pair in Treating Hepatocellular Carcinoma. Drug Des Devel Ther 2024; 18:2169-2187. [PMID: 38882048 PMCID: PMC11179675 DOI: 10.2147/dddt.s459593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Accepted: 05/24/2024] [Indexed: 06/18/2024] Open
Abstract
Purpose Traditional Chinese medicine (TCM) therapy is an important means to treat hepatocellular carcinoma (HCC), Astragalus (Latin name: Hedysarum Multijugum Maxim; Chinese name: Huangqi, HQ) and Atractylodes (Latin name: Atractylodes Macrocephala Koidz; Chinese name: Baizhu, BZ) (HQBZ), a classic herb pair, is often used in combination to HCC. However, the main components and potential mechanisms of HQBZ therapy in HCC remain unclear. This study aimed to identify the potential active ingredients and molecular mechanisms of action of HQBZ in HCC treatment. Methods The HQBZ-Compound-Target-HCC network and HQBZ-HCC transcriptional regulatory network were constructed to screen the core active compound components and targets of HQBZ therapy for HCC. Molecular docking techniques are used to verify the stability of binding core active compound components to targets. GO and KEGG enrichment analysis were used to explore the signaling pathway of HQBZ in HCC treatment, the mechanism of HQBZ treatment of HCC was verified based on in vivo H22 tumor bearing mice and in vitro cell experiments. Results Network pharmacology and molecular docking studies showed that HQBZ treatment of HCC was related to the targeted regulation of IL-6 and STAT3 by the active compound biatractylolide, KEGG pathway enrichment analysis suggest that HQBZ may play a role in the treatment of HCC through IL-6/STAT3 signaling pathway. In vitro experiment results proved that HQBZ could regulate IL-6/STAT3 signaling pathway transduction on CD8+T cells, inhibit CD8+T cell exhaustion and restore the function of exhausted CD8+T cells. In vivo experiment results proved that HQBZ can regulate IL-6/STAT3 signaling pathway transduction in H22 liver cancer model mouse tumor tissue, increased the proportion of tumor infiltrating CD8+T cells. Conclusion This study found that HQBZ may play a therapeutic role in HCC by targeting IL-6 and STAT3 through biatractylolide, its mechanism of action is related to regulating IL-6/STAT3 signaling pathway, reversing T cell failure and increasing tumor infiltration CD8+T cells.
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MESH Headings
- Carcinoma, Hepatocellular/drug therapy
- Carcinoma, Hepatocellular/pathology
- Carcinoma, Hepatocellular/metabolism
- Liver Neoplasms/drug therapy
- Liver Neoplasms/pathology
- Liver Neoplasms/metabolism
- Animals
- Humans
- Drugs, Chinese Herbal/pharmacology
- Drugs, Chinese Herbal/chemistry
- Network Pharmacology
- Mice
- STAT3 Transcription Factor/metabolism
- STAT3 Transcription Factor/antagonists & inhibitors
- Atractylodes/chemistry
- Antineoplastic Agents, Phytogenic/pharmacology
- Antineoplastic Agents, Phytogenic/chemistry
- Antineoplastic Agents, Phytogenic/isolation & purification
- Molecular Docking Simulation
- Astragalus Plant/chemistry
- Cell Proliferation/drug effects
- Liver Neoplasms, Experimental/drug therapy
- Liver Neoplasms, Experimental/pathology
- Liver Neoplasms, Experimental/metabolism
- Interleukin-6/metabolism
- Interleukin-6/antagonists & inhibitors
- Medicine, Chinese Traditional
- Drug Screening Assays, Antitumor
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Affiliation(s)
- Yuling Liang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Yuqing Xie
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Xiaoli Liu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Lihua Yu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Huiwen Yan
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Zimeng Shang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Yuan Wu
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Xue Cai
- Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Wanxin Shi
- Beijing University of Chinese Medicine, Beijing, 100029, People's Republic of China
| | - Juan Du
- Beijing Key Laboratory of Emerging Infectious Diseases, Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
| | - Zhiyun Yang
- Center of Integrative Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing, 100015, People's Republic of China
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2
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Pinto E, Pelizzaro F, Cardin R, Battistel M, Palano G, Bertellini F, Kitenge MP, Peserico G, Farinati F, Russo FP. HIF-1α and VEGF as prognostic biomarkers in hepatocellular carcinoma patients treated with transarterial chemoembolization. Dig Liver Dis 2024; 56:872-879. [PMID: 37783655 DOI: 10.1016/j.dld.2023.09.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 10/04/2023]
Abstract
BACKGROUND Neoangiogenesis plays a crucial role in the progression of hepatocellular carcinoma (HCC), and concerns have been raised about the role of neoangiogenesis on the effectiveness of transarterial chemoembolization (TACE). AIM In this study, we aimed to evaluate Vascular Endothelial Growth Factor (VEGF) and Hypoxia-Inducible Factor-1α (HIF-1α) as circulating prognostic biomarkers in HCC patients treated with TACE. METHODS Blood samples were collected from 163 patients before (t0) and four weeks after TACE (t1). RESULTS Higher levels of VEGF after TACE were demonstrated (264.0 [78.7-450.8] vs. 278.6 [95.0-576.6] pg/mL; p < 0.0001). Responders to TACE had lower levels of VEGF than non-responders both at t0 (200.0 [58.9-415.8] vs. 406.6 [181.4-558.6] pg/mL; p = 0.006) and at t1 (257.3 [68.5-528.6] vs. 425.9 [245.2-808.3] pg/mL; p = 0.003), and in both groups there was an increase in VEGF compared to measurements before treatment (p = 0.001 and p = 0.005, respectively). VEGF was not associated with overall survival (OS), while patients with HIF-1α ≤ 0.49 ng/mL showed better prognosis (median OS 28.0 months [95% CI 19.7-36.3] vs. 17.0 months [95% CI 11.1-22.9]; p = 0.01). Moreover, HIF-1α was identified as an independent prognostic parameter. CONCLUSIONS VEGF and HIF-1α can be considered useful prognostic biomarkers in HCC patients treated with TACE.
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Affiliation(s)
- Elisa Pinto
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Filippo Pelizzaro
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Romilda Cardin
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy
| | - Michele Battistel
- Radiology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Giorgio Palano
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Federica Bertellini
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Maria Piera Kitenge
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
| | - Giulia Peserico
- Gastroenterology Unit, Veneto Institute of Oncology (IOV), Padova, Italy
| | - Fabio Farinati
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy.
| | - Francesco Paolo Russo
- Department of Surgery, Oncology and Gastroenterology, University of Padova, Padova, Italy; Gastroenterology Unit, Azienda Ospedale-Università di Padova, Padova, Italy
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3
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Karimi A, Yarmohammadi H, Erinjeri JP. Immune Effects of Intra-Arterial Liver-Directed Therapies. J Vasc Interv Radiol 2024; 35:178-184. [PMID: 38272638 DOI: 10.1016/j.jvir.2023.10.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 10/08/2023] [Accepted: 10/21/2023] [Indexed: 01/27/2024] Open
Abstract
Image-guided intra-arterial locoregional therapies (LRTs) such as transarterial embolization, transarterial chemoembolization, and transarterial radioembolization exhibit effects on the immune system. Understanding the humoral (cytokine, chemokine, and growth factor) and cellular (T cell, neutrophil, dendritic cell, and macrophage) mechanisms underlying the immune effects of LRT is crucial to designing rational and effective combinations of immunotherapy and interventional radiology procedures. This article aims to review the immune effects of intra-arterial LRTs and provide insight into strategies to combine LRTs with systemic immunotherapy.
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Affiliation(s)
- Anita Karimi
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hooman Yarmohammadi
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph P Erinjeri
- Interventional Radiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York.
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Moradi-Gharibvand N, Hashemibeni B. The Effect of Stem Cells and Vascular Endothelial Growth Factor on Cancer Angiogenesis. Adv Biomed Res 2023; 12:124. [PMID: 37434939 PMCID: PMC10331557 DOI: 10.4103/abr.abr_378_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 04/17/2022] [Accepted: 04/24/2022] [Indexed: 07/13/2023] Open
Abstract
The formation of new vessels from pre-existing vessels is known as angiogenesis. The process is controlled by stimuli and inhibitors. Angiogenesis starts as a result of the unbalance of these factors, where balance has a tendency toward the stimulus. One of the most important factors promoting angiogenesis is the vascular endothelial growth factor (VEGF). In addition to being involved in vascular regeneration in normal tissues, VEGF also takes part in tumor tissue angiogenesis. These factors affect endothelial cells (ECs) directly as well as differentiate tumor cells from endothelial cells and play an active role in tumor tissue angiogenesis. Angiogenesis partakes in the growth and proliferation of tumor tissue. Because anti-angiogenic treatment is favorable in existing cancer therapies, the potential benefits should be considered. One of these new therapies is cell therapy using mesenchymal stem cells (MSCs). Research on MSCs remains controversial because much of the earlier research on MSCs has shown their effectiveness, but more recent research has identified harmful effects of these cells. This article reviews the role of stem cells and their secretions in the angiogenesis of tumor tissues.
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Affiliation(s)
- Nahid Moradi-Gharibvand
- Abadan University of Medical Sciences, Abadan, Iran
- Department of Anatomical Sciences and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Batool Hashemibeni
- Department of Anatomical Sciences and Molecular Biology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
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Huynh KN, Rao S, Roth B, Bryan T, Fernando DM, Dayyani F, Imagawa D, Abi-Jaoudeh N. Targeting Hypoxia-Inducible Factor-1α for the Management of Hepatocellular Carcinoma. Cancers (Basel) 2023; 15:2738. [PMID: 37345074 DOI: 10.3390/cancers15102738] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 06/23/2023] Open
Abstract
Hypoxia-inducible factor 1 alpha (HIF-1α) is a transcription factor that regulates the cellular response to hypoxia and is upregulated in all types of solid tumor, leading to tumor angiogenesis, growth, and resistance to therapy. Hepatocellular carcinoma (HCC) is a highly vascular tumor, as well as a hypoxic tumor, due to the liver being a relatively hypoxic environment compared to other organs. Trans-arterial chemoembolization (TACE) and trans-arterial embolization (TAE) are locoregional therapies that are part of the treatment guidelines for HCC but can also exacerbate hypoxia in tumors, as seen with HIF-1α upregulation post-hepatic embolization. Hypoxia-activated prodrugs (HAPs) are a novel class of anticancer agent that are selectively activated under hypoxic conditions, potentially allowing for the targeted treatment of hypoxic HCC. Early studies targeting hypoxia show promising results; however, further research is needed to understand the effects of HAPs in combination with embolization in the treatment of HCC. This review aims to summarize current knowledge on the role of hypoxia and HIF-1α in HCC, as well as the potential of HAPs and liver-directed embolization.
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Affiliation(s)
- Kenneth N Huynh
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Sriram Rao
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Bradley Roth
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Theodore Bryan
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Dayantha M Fernando
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
| | - Farshid Dayyani
- Division of Hematology and Oncology, Department of Medicine, Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA 92868, USA
| | - David Imagawa
- Division of Hepatobiliary and Pancreas Surgery, Department of Surgery, University of California Irvine, Orange, CA 92868, USA
| | - Nadine Abi-Jaoudeh
- Division of Interventional Radiology, Department of Radiological Sciences, University of California Irvine, Orange, CA 92868, USA
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6
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Fessas P, Scheiner B, D'Alessio A, M Fulgenzi CA, Korolewicz J, Ward C, Tait P, Thomas R, Cortellini A, Sharma R, Pinato DJ. PETAL protocol: a phase Ib study of pembrolizumab after transarterial chemoembolization in hepatocellular carcinoma. Future Oncol 2023; 19:499-507. [PMID: 37097715 DOI: 10.2217/fon-2022-0916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023] Open
Abstract
Transarterial chemoembolization (TACE) is the treatment of choice for intermediate-stage hepatocellular carcinoma (HCC). Recent data suggest that TACE may boost the efficacy of anti-PD-1 immunotherapy. The authors present the trial protocol for PETAL, a phase Ib study, which will assess the safety and bioactivity of pembrolizumab, an anti-PD-1 antibody, following TACE in HCC. After a run-in phase evaluating six patients to establish preliminary safety, up to 26 additional participants will be enrolled. Pembrolizumab will be administered three-times weekly for 1 year or until progression, starting 30-45 days after TACE. The primary objective is to determine safety and the secondary objective is to preliminarily evaluate efficacy. Radiological responses will be evaluated every four cycles. Clinical Trial Registration: NCT03397654 (ClinicalTrials.gov).
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Affiliation(s)
- Petros Fessas
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - Bernhard Scheiner
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
- Department of Radiology, Imperial College NHS Trust, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - Antonio D'Alessio
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
- Liver Cancer (HCC) Study Group, Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Claudia A M Fulgenzi
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072, Pieve Emanuele, Milan, Italy
| | - James Korolewicz
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - Caroline Ward
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - Paul Tait
- Department of Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Robert Thomas
- Department of Medical Oncology, University Campus Bio-Medico of Rome, Rome, Italy
| | - Alessio Cortellini
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - Rohini Sharma
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, Du Cane Road, W120HS, London, UK
- Division of Oncology, Department of Translational Medicine, University of Piemonte Orientale, Novara, Italy
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7
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He K, Liu X, Yang Z. Development and Validation of a Vascular Endothelial Growth Factor A-associated Prognostic Model for Unresectable Hepatocellular Carcinoma. J Hepatocell Carcinoma 2023; 10:139-156. [PMID: 36777498 PMCID: PMC9910209 DOI: 10.2147/jhc.s399299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/26/2023] [Indexed: 02/05/2023] Open
Abstract
Purpose High serum vascular endothelial growth factor (VEGF) levels have been identified as an independent risk factor for hepatocellular carcinoma (HCC). We aimed to construct a VEGF-included prognostic model to accurately perform individualized predictions of survival probability for patients with unresectable HCC. Patients and Methods From October 2018 to March 2021, 182 consecutive newly diagnosed patients with unresectable HCC were retrospectively enrolled. Baseline serum VEGF-A and other characteristics were collected for all patients. Univariate Cox regression analysis and LASSO regression model were applied to develop the prognostic model, enhanced bootstrap method with 100 replicates was performed to validate its discrimination and calibration. We compared the final model with China Liver Cancer (CNLC) stage, American Joint Committee on Cancer (AJCC) stage, Barcelona Clinic Liver Cancer (BCLC) stage, and the model without the "VEGF". Finally, the established model was stratified by age. Results The VEGF-associated prognostic model we established has high accuracy with an overall C-index of 0.7892 after correction for optimistic estimates. The area under the curve (AUC) of the time-dependent receiver operating characteristic (ROC) curves at 6-month, 1-year, and 2-year after correction were 0.843, 0.860, 0.833, respectively, and the calibration of the model was 0.1153, 0.1514, and 0.1711, respectively. The final model showed significant improvement in predicting OS when compared to the other models according to Harrell's C-index, The AUC of the time-dependent ROC, area under the decision curve analysis (AUDC), integrated discrimination improvement (IDI), and continuous net reclassification index (NRI). Conclusion The VEGF-associated prognostic model may help to predict the survival probabilities of HCC patients with favorable performance and discrimination. However, further validation is required since we only verified this model using internal but not external data.
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Affiliation(s)
- Kun He
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Xinyu Liu
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China
| | - Zelong Yang
- Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, People’s Republic of China,Correspondence: Zelong Yang, Department of Hepatobiliary Surgery, Xijing Hospital, Fourth Military Medical University, No. 15, Changle West Road, Xi’an, People’s Republic of China, Tel +86 17795714179, Email
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Beaton L, Tregidgo HFJ, Znati SA, Forsyth S, Counsell N, Clarkson MJ, Bandula S, Chouhan M, Lowe HL, Thin MZ, Hague J, Sharma D, Pollok JM, Davidson BR, Raja J, Munneke G, Stuckey DJ, Bascal ZA, Wilde PE, Cooper S, Ryan S, Czuczman P, Boucher E, Hartley JA, Atkinson D, Lewis AL, Jansen M, Meyer T, Sharma RA. Phase 0 Study of Vandetanib-Eluting Radiopaque Embolics as a Preoperative Embolization Treatment in Patients with Resectable Liver Malignancies. J Vasc Interv Radiol 2022; 33:1034-1044.e29. [PMID: 35526675 DOI: 10.1016/j.jvir.2022.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 04/03/2022] [Accepted: 04/21/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To assess the safety and tolerability of a vandetanib-eluting radiopaque embolic (BTG-002814) for transarterial chemoembolization (TACE) in patients with resectable liver malignancies. MATERIALS AND METHODS The VEROnA clinical trial was a first-in-human, phase 0, single-arm, window-of-opportunity study. Eligible patients were aged ≥18 years and had resectable hepatocellular carcinoma (HCC) (Child-Pugh A) or metastatic colorectal cancer (mCRC). Patients received 1 mL of BTG-002814 transarterially (containing 100 mg of vandetanib) 7-21 days prior to surgery. The primary objectives were to establish the safety and tolerability of BTG-002814 and determine the concentrations of vandetanib and the N-desmethyl vandetanib metabolite in the plasma and resected liver after treatment. Biomarker studies included circulating proangiogenic factors, perfusion computed tomography, and dynamic contrast-enhanced magnetic resonance imaging. RESULTS Eight patients were enrolled: 2 with HCC and 6 with mCRC. There was 1 grade 3 adverse event (AE) before surgery and 18 after surgery; 6 AEs were deemed to be related to BTG-002814. Surgical resection was not delayed. Vandetanib was present in the plasma of all patients 12 days after treatment, with a mean maximum concentration of 24.3 ng/mL (standard deviation ± 13.94 ng/mL), and in resected liver tissue up to 32 days after treatment (441-404,000 ng/g). The median percentage of tumor necrosis was 92.5% (range, 5%-100%). There were no significant changes in perfusion imaging parameters after TACE. CONCLUSIONS BTG-002814 has an acceptable safety profile in patients before surgery. The presence of vandetanib in the tumor specimens up to 32 days after treatment suggests sustained anticancer activity, while the low vandetanib levels in the plasma suggest minimal release into the systemic circulation. Further evaluation of this TACE combination is warranted in dose-finding and efficacy studies.
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Affiliation(s)
- Laura Beaton
- University College London Cancer Institute, University College London, London, United Kingdom.
| | - Henry F J Tregidgo
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Sami A Znati
- University College London Cancer Institute, University College London, London, United Kingdom
| | - Sharon Forsyth
- Cancer Research UK and University College London Cancer Trials Centre, University College London, London, United Kingdom
| | - Nicholas Counsell
- Cancer Research UK and University College London Cancer Trials Centre, University College London, London, United Kingdom
| | - Matthew J Clarkson
- Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Steven Bandula
- University College London Centre for Medical Imaging, University College London, London, United Kingdom
| | - Manil Chouhan
- University College London Centre for Medical Imaging, University College London, London, United Kingdom
| | - Helen L Lowe
- University College London Experimental Cancer Medicine Centre Good Clinical Laboratory Practice Facility, University College London, London, United Kingdom
| | - May Zaw Thin
- Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - Julian Hague
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Dinesh Sharma
- Division of Transplantation and Immunology, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Joerg-Matthias Pollok
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Hepatopancreatobiliary Surgery and Liver Transplantation, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Brian R Davidson
- Division of Surgery and Interventional Science, University College London, London, United Kingdom; Hepatopancreatobiliary Surgery and Liver Transplantation, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Jowad Raja
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Graham Munneke
- University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Daniel J Stuckey
- Centre for Advanced Biomedical Imaging, University College London, London, United Kingdom
| | - Zainab A Bascal
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Paul E Wilde
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Sarah Cooper
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Samantha Ryan
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Peter Czuczman
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Eveline Boucher
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - John A Hartley
- University College London Cancer Institute, University College London, London, United Kingdom; University College London Experimental Cancer Medicine Centre Good Clinical Laboratory Practice Facility, University College London, London, United Kingdom
| | - David Atkinson
- University College London Centre for Medical Imaging, University College London, London, United Kingdom
| | - Andrew L Lewis
- Biocompatibles UK Ltd, Lakeview, Riverside Way, Watchmoor Park, Camberley, Surrey, United Kingdom
| | - Marnix Jansen
- University College London Cancer Institute, University College London, London, United Kingdom; University College London Hospitals NHS Foundation Trust, London, United Kingdom
| | - Tim Meyer
- University College London Cancer Institute, University College London, London, United Kingdom; Department of Oncology, Royal Free Hospital NHS Foundation Trust, London, United Kingdom
| | - Ricky A Sharma
- National Institute for Health Research University College London Hospitals Biomedical Centre, University College London Cancer Institute, London, United Kingdom
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Liu J, Zhang L, Zhao D, Yue S, Sun H, Ni C, Zhong Z. Polymersome-stabilized doxorubicin-lipiodol emulsions for high-efficacy chemoembolization therapy. J Control Release 2022; 350:122-131. [PMID: 35973474 DOI: 10.1016/j.jconrel.2022.08.015] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 08/03/2022] [Accepted: 08/10/2022] [Indexed: 02/08/2023]
Abstract
Transarterial chemoembolization (TACE) with free doxorubicin-lipiodol emulsions (free DOX/L) is a favored clinical treatment for advanced hepatocellular carcinoma (HCC) patients ineligible for radical therapies; however, its inferior colloidal stability not only greatly reduces its tumor retention but also hastens drug release into blood circulation, leading to suboptimal clinical outcomes. Here, we find that disulfide-crosslinked polymersomes carrying doxorubicin (Ps-DOX) form super-stable and homogenous water-in-oil microemulsions with lipiodol (Ps-DOX/L). Ps-DOX/L microemulsions had tunable sizes ranging from 14 to 44 μm depending on the amount of Ps-DOX, were stable over 2 months storage as well as centrifugation, and exhibited nearly zero-order DOX release within 15 days. Of note, Ps-DOX induced 2.3-13.4 fold better inhibitory activity in all tested rat, murine and human liver tumor cells than free DOX likely due to its efficient redox-triggered intracellular drug release. Interestingly, transarterial administration of Ps-DOX/L microemulsions in orthotopic rat N1S1 syngeneic HCC model showed minimal systemic DOX exposure, high and long hepatic DOX retention, complete tumor elimination, effective inhibition of angiogenesis, and depleted adverse effects, significantly outperforming clinically used free DOX/L emulsions. This smart polymersome stabilization of doxorubicin-lipiodol microemulsions provides a novel TACE strategy for advanced tumors.
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Affiliation(s)
- Jingyi Liu
- Biomedical Polymers Laboratory, College of Chemistry, Chemical Engineering and Materials Science, and State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, PR China
| | - Lei Zhang
- Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215123, PR China
| | - Dongxu Zhao
- Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215123, PR China
| | - Shujing Yue
- Biomedical Polymers Laboratory, College of Chemistry, Chemical Engineering and Materials Science, and State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, PR China
| | - Huanli Sun
- Biomedical Polymers Laboratory, College of Chemistry, Chemical Engineering and Materials Science, and State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, PR China.
| | - Caifang Ni
- Department of Interventional Radiology, The First Affiliated Hospital of Soochow University, Suzhou 215123, PR China.
| | - Zhiyuan Zhong
- Biomedical Polymers Laboratory, College of Chemistry, Chemical Engineering and Materials Science, and State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, PR China; College of Pharmaceutical Sciences, and State Key Laboratory of Radiation Medicine and Protection, Soochow University, Suzhou 215123, PR China.
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10
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Wang XB, Sun LF, Niu ME, Cai JZ, Wang HF. The Effect of Nursing Management of Patients Undergoing Interventional Therapy for Liver Cancer Compared with Standard Care on Patient-Reported Outcomes. Clin Nurs Res 2022; 31:1100-1106. [PMID: 35450451 DOI: 10.1177/10547738221090556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND To investigate the efficacy of individualized symptom management based on patients' self-reports during interventional therapy (IT) for liver cancer. METHODS Patients with liver cancer who received IT at First Affiliated Hospital of ****** University from April to August 2019 were apportioned to either an intervention or control group (n = 70 each). The control group received routine nursing care and the intervention group received a nursing management program. The severity of specific symptoms, as measured by the Karnofsky Performance Scale (KPS), and satisfaction with nursing care, were analyzed. RESULTS Compared to the control group, patients given individualized management experienced significantly less severe pain, nausea, anxiety, and fatigue (p < .05). The scores for KPS and satisfaction with care were both significantly improved in the intervention group than in the control group (p < .05). CONCLUSION This high-quality nursing management program predicated on patients' self-reports is worthy of clinical application and popular adoption.
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Affiliation(s)
- Xiu-Bei Wang
- First Affiliated Hospital of Soochow University, Suzhou, China
| | - Ling-Fang Sun
- First Affiliated Hospital of Soochow University, Suzhou, China
| | - Mei-E Niu
- First Affiliated Hospital of Soochow University, Suzhou, China
| | - Jian-Zheng Cai
- First Affiliated Hospital of Soochow University, Suzhou, China
| | - Hai-Fang Wang
- First Affiliated Hospital of Soochow University, Suzhou, China
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11
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Biondetti P, Saggiante L, Ierardi AM, Iavarone M, Sangiovanni A, Pesapane F, Fumarola EM, Lampertico P, Carrafiello G. Interventional Radiology Image-Guided Locoregional Therapies (LRTs) and Immunotherapy for the Treatment of HCC. Cancers (Basel) 2021; 13:5797. [PMID: 34830949 PMCID: PMC8616392 DOI: 10.3390/cancers13225797] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/16/2021] [Accepted: 11/16/2021] [Indexed: 12/12/2022] Open
Abstract
Image-guided locoregional therapies (LRTs) are a crucial asset in the treatment of hepatocellular carcinoma (HCC), which has proven to be characterized by an impaired antitumor immune status. LRTs not only directly destroy tumor cells but also have an immunomodulating role, altering the tumor microenvironment with potential systemic effects. Nevertheless, the immune activation against HCC induced by LRTs is not strong enough on its own to generate a systemic significant antitumor response, and it is incapable of preventing tumor recurrence. Currently, there is great interest in the possibility of combining LRTs with immunotherapy for HCC, as this combination may result in a mutually beneficial and synergistic relationship. On the one hand, immunotherapy could amplify and prolong the antitumoral immune response of LRTs, reducing recurrence cases and improving outcome. On the other hand, LTRs counteract the typical immunosuppressive HCC microenvironment and status and could therefore enhance the efficacy of immunotherapy. Here, after reviewing the current therapeutic options for HCC, we focus on LRTs, describing for each of them the technique and data on its effect on the immune system. Then, we describe the current status of immunotherapy and finally report the recently published and ongoing clinical studies testing this combination.
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Affiliation(s)
- Pierpaolo Biondetti
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (A.M.I.); (G.C.)
| | - Lorenzo Saggiante
- Postgraduate School in Radiodiagnostics, Università degli Studi di Milano, 20122 Milan, Italy;
| | - Anna Maria Ierardi
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (A.M.I.); (G.C.)
| | - Massimo Iavarone
- Gastroenterology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (M.I.); (A.S.); (P.L.)
| | - Angelo Sangiovanni
- Gastroenterology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (M.I.); (A.S.); (P.L.)
| | - Filippo Pesapane
- Radiology Department, IEO European Institute of Oncology IRCCS, 20122 Milan, Italy;
| | - Enrico Maria Fumarola
- Diagnostic and Interventional Radiology Department, ASST Santi Paolo e Carlo, 20122 Milan, Italy;
| | - Pietro Lampertico
- Gastroenterology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (M.I.); (A.S.); (P.L.)
| | - Gianpaolo Carrafiello
- Diagnostic and Interventional Radiology Department, IRCCS Cà Granda Fondazione Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy; (A.M.I.); (G.C.)
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12
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Pan X, Kaminga AC, Wen SW, Liu A. Chemokines in hepatocellular carcinoma: a meta-analysis. Carcinogenesis 2021; 41:1682-1694. [PMID: 33300549 DOI: 10.1093/carcin/bgaa106] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/17/2020] [Accepted: 10/08/2020] [Indexed: 12/17/2022] Open
Abstract
Accumulating evidence suggests that chemokines may play an important role in the formation and mediating of the immune microenvironment of hepatocellular carcinoma (HCC). The purpose of this meta-analysis was to explore the differences in blood or tissues chemokines concentrations between HCC patients and controls. Online databases, namely PubMed, Web of Science, Embase and Cochrane Library, were systematically searched for relevant articles published on or before 15 January 2020. Standardized mean differences (SMDs) with corresponding 95% confidence intervals of the chemokines concentrations were calculated as group differences between the HCC patients and the controls. Sixty-five studies met the inclusion criteria for the meta-analysis. Altogether they consisted of 26 different chemokines compared between 5828 HCC patients and 4909 controls; and 12 different chemokines receptors compared between 2053 patients and 2285 controls. The results of meta-analysis indicated that concentrations of CCL20, CXCL8 and CXCR4 in the HCC patients were significantly higher than those in the controls (SMD of 6.18, 1.81 and 1.04, respectively). Therefore, higher concentration levels of CCL20, CXCL8 and CXCR4 may indicate the occurrence of HCC Future research should explore the putative mechanisms underlying this linkage. Meanwhile, attempts can be made to replicate the existing findings in prospective cohort populations and explore the cause-and-effect relationships pertaining to this linkage in order to develop new diagnostic and therapeutic strategies for HCC.
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Affiliation(s)
- Xiongfeng Pan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Atipatsa C Kaminga
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.,Department of Mathematics and Statistics, Mzuzu University, Mzuzu, Malawi
| | - Shi Wu Wen
- OMNI Research Group, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.,Department of Obstetrics and Gynaecology, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada.,School of Epidemiology and Public Health, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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13
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Qiu Z, Shen L, Jiang Y, Qiu J, Xu Z, Shi M, Yu Z, Ma Y, He W, Zheng Y, Li B, Wang G, Yuan Y. Transarterial chemoembolization (TACE) combined with apatinib versus TACE combined with sorafenib in advanced hepatocellular carcinoma patients: a multicenter retrospective study. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:283. [PMID: 33708910 PMCID: PMC7944263 DOI: 10.21037/atm-20-5360] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The combination of transarterial chemoembolization (TACE) with sorafenib has demonstrated superior efficacy over sorafenib and TACE monotherapy in hepatocellular carcinoma (HCC). Apatinib, a new targeted agent, has been recently reported to prolong the survival of HCC patients, either alone or in combination with TACE. However, the superior regimen between TACE-apatinib and TACE-sorafenib in HCC patients has not been determined. In this study, we compared the efficacy and safety of TACE-apatinib versus TACE-sorafenib in advanced stage HCC patients. Methods The data of 201 HCC patients who had received TACE-sorafenib or TACE-apatinib between January 2016 and June 2018 in three hospitals were retrospectively reviewed. Overall survival (OS), progression-free survival (PFS), and adverse effects (AEs) between the two treatment groups were compared. A subgroup analysis based on the doses of targeted agents was also performed. Results No significant differences in baseline clinicopathological features were found between the two groups except for dose reduction. The TACE-apatinib group had higher incidences of hypertension, oral or anal ulcer and proteinuria, while the TACE-sorafenib group had higher incidences of diarrhea and alopecia. Grade 3/4 AEs occurred more frequently in the TACE-apatinib group than in the TACE-sorafenib group (52.3% vs. 22.6%, P<0.001). The TACE-sorafenib group had better PFS than the TACE-apatinib group (median PFS: 5.0 vs. 6.0 months, P=0.002) while the two groups showed no difference in OS (median OS: 13.0 vs. 13.0 months, P=0.448). The TACE-apatinib group had a higher rate of targeted agent dose reduction than the TACE-sorafenib group (53.5% vs. 17.4%, P<0.001). When the patients were stratified into normal and reduced-dose subgroups, those who received TACE-sorafenib exhibited improved PFS but similar OS compared with the patients who received TACE-apatinib in the reduced-dose subgroup (median OS: 12.0 vs. 13.3 months, P=0.614; median PFS: 3.0 vs. 7.0 months, P<0.001). Multivariable analysis validated that treatments and dose reduction were independent prognostic factors for PFS among all patients. Conclusions Compared with TACE-sorafenib, the strategy of TACE-apatinib yielded shorter PFS in advanced HCC patients while no difference in OS was observed. A high rate of AE-related dose reduction of apatinib could account for the observed differences.
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Affiliation(s)
- Zhiyu Qiu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Lujun Shen
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yiquan Jiang
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Minimally Invasive Interventional Therapy, Sun Yat-sen University Cancer Center, Guangzhou, China.,Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Jiliang Qiu
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zining Xu
- Department of Minimally Invasive Interventional Radiology, the Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Mengting Shi
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Zhentao Yu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Yanping Ma
- Department of Radiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei He
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yun Zheng
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Binkui Li
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Guoying Wang
- Department of Hepatic Surgery and Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Yunfei Yuan
- State Key Laboratory of Oncology in South China and Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University, Guangzhou, China.,Department of Liver Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China
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14
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Farid K, Elalfy H, Abo El-Khair SM, Elgamal H, Besheer T, Elmokadem A, Shabana W, Abed S, Elegezy M, El-Khalek AA, El-Morsy A, Negm A, Elsamanoudy AZ, El Deek B, Amer T, El-Bendary M. Prognostic value of vascular endothelial growth factor in both conventional and drug eluting beads transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma in HCV patients. Expert Rev Gastroenterol Hepatol 2020; 14:1203-1214. [PMID: 32933325 DOI: 10.1080/17474124.2020.1823215] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug-eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence. METHODS 114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus-related cirrhosis were included. They underwent cTACE (58) or DEB-TACE (56). VEGF serum levels were measured before and on days 1 and 30 after TACE. Patients with complete response (CR) after TACE were followed-up for one year. Statistical analysis was done. RESULTS VEGF level was higher than baseline after cTACE (P < 0.001), and DEB-TACE (P = 0.004). It was also significantly higher in patients with progressive disease (P < 0.001). VEGF level at cut off values of 97.3, 149.8, and 104.1 pg/ml could discriminate disease progression from treatment success with area under ROC curves of 0.806, 0.775, and 0.771, respectively. The sensitivity was 88.9%, 88.9%, and 77.8% and specificity was 62.5%, 64.6 and 66.7%, respectively. However, no relation to tumor recurrence in CR group could be detected after one year. CONCLUSION VEGF serum levels may predict response to therapy in patients treated by DEB-TACE or cTACE but it has no relation to tumor recurrence.
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Affiliation(s)
- Khaled Farid
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Hatem Elalfy
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Salwa M Abo El-Khair
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Hoda Elgamal
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Tarek Besheer
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Ali Elmokadem
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Walaa Shabana
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Sally Abed
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Mohamed Elegezy
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Ahmed Abd El-Khalek
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Ahmed El-Morsy
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Amr Negm
- Chemistry Department, Faculty of Science, Mansoura University , Mansoura, Egypt
| | - Ayman Z Elsamanoudy
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Mansoura University , Mansoura, Egypt.,Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University , Jeddah, Saudi Arabia
| | - Basem El Deek
- Community Medicine, Delta University of Science and Technology , Mansoura, Egypt
| | - Talal Amer
- Diagnostic and Interventional Radiology Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
| | - Mahmoud El-Bendary
- Tropical Medicine Department, Faculty of Medicine, Mansoura University , Mansoura, Egypt
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15
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Yang H. Fever is not good after transarterial chemoembolization for hepatocellular carcinoma. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Hung‐Chih Yang
- Department of MicrobiologyNational Taiwan University College of Medicine Taipei Taiwan
- Department of Internal MedicineNational Taiwan University Hospital Taipei Taiwan
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16
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Peng C, Teng W, Hsieh Y, Jeng W, Huang C, Lui K, Hung C, Chen Y, Lin C, Lin C, Lin S, Sheen I. Postembolization fever after transarterial chemoembolization is a sign of unfavorable therapeutic response in hepatocellular carcinoma patients. ADVANCES IN DIGESTIVE MEDICINE 2020. [DOI: 10.1002/aid2.13182] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Chien‐Wei Peng
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Wei Teng
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Yi‐Chung Hsieh
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Wen‐Juei Jeng
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Chien‐Hao Huang
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Kar‐Wai Lui
- College of Medicine, Chang Gung University Taipei Taiwan
- Department of RadiologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
| | - Chen‐Fu Hung
- College of Medicine, Chang Gung University Taipei Taiwan
- Department of RadiologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
| | - Yi‐Cheng Chen
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Chen‐Chun Lin
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Chun‐Yen Lin
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - Shi‐Ming Lin
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
| | - I‐Shyan Sheen
- Department of Gastroenterology and HepatologyChang Gung Memorial Hospital, Linkou Branch Taoyuan Taiwan
- College of Medicine, Chang Gung University Taipei Taiwan
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17
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Wu Y, Fan W, Xue M, Zhong B, Zhang S, Wang Y, Yao W, Zhao Y, Li J. Postintervention Interleukin-6 (IL-6) Level, Rather than the Pretreatment or Dynamic Changes of IL-6, as an Early Practical Marker of Tumor Response in Hepatocellular Carcinoma Treated with Transarterial Chemoembolization. Oncologist 2019; 24:e1489-e1495. [PMID: 31249138 DOI: 10.1634/theoncologist.2018-0669] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 04/23/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The aim of this study was to determine the potential prognostic roles of the perioperative interleukin-6 (IL-6) level and its dynamic changes in patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE). MATERIALS AND METHODS Sixty patients with hepatitis B virus-associated HCC receiving TACE were enrolled in the study. Serum IL-6 levels were determined at baseline and 1 day after TACE by immunoassay. Response to TACE was evaluated after a 4-6-week interval. Factors associated with tumor response were analyzed by univariate and multivariate analysis in a Cox regression model. Receiver operating characteristic (ROC) curve analysis was performed to assess the predictive performance of the included variables on tumor response in patients with HCC undergoing TACE. RESULTS The serum IL-6 level was significantly elevated 1 day after TACE. Patients in the low postintervention IL-6 level group had a high probability of achieving an objective response (OR) (66.7% vs. 18.8%, p = .021). Post-TACE IL-6 level (≤12.7 pg/mL) and post-/pre-TACE neutrophils ratio (>2.47) were independently correlated with OR after TACE. ROC curve analysis showed that a combined index based on those two factors exhibited optimal predictive power of tumor response among all the included variables (area under the curve = 0.740, 95% confidence interval: 0.601-0.879). Additionally, high post-TACE plasma IL-6 level was associated with maximum tumor size, vascular invasion, post-TACE aspartate aminotransferase, and Barcelona Clinic Liver Cancer stage. CONCLUSION Our study suggests that the post-treatment serum IL-6 level, rather than pretreatment or dynamic changes of IL-6, serves as a powerful predictor for tumor response. These findings provide evidence to help discriminate between patients who will particularly benefit from TACE and those who require more personalized therapeutic regimens and rigorous surveillance. IMPLICATIONS FOR PRACTICE Transarterial chemoembolization (TACE) is a major therapeutic regimen for advanced hepatocellular carcinoma. Thus, identification of early practical markers of tumor response to TACE is of high importance. This study indicated that the post-treatment serum interleukin-6 (IL-6) level, rather than the pretreatment or dynamic changes of IL-6, serves as a powerful predictor for tumor response. A combined index based on the post-TACE IL-6 level and post-/pre-TACE neutrophils ratio is optimal for predetermining an objective response after TACE, which may be helpful in guiding individualized treatments and surveillance.
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Affiliation(s)
- Yanqin Wu
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Wenzhe Fan
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Miao Xue
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Bihui Zhong
- Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Shenghong Zhang
- Department of Gastroenterology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yu Wang
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Wang Yao
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Yue Zhao
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
| | - Jiaping Li
- Department of Interventional Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People's Republic of China
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18
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Dong G, Lin XH, Liu HH, Gao DM, Cui JF, Ren ZG, Chen RX. Intermittent hypoxia alleviates increased VEGF and pro-angiogenic potential in liver cancer cells. Oncol Lett 2019; 18:1831-1839. [PMID: 31423251 PMCID: PMC6607353 DOI: 10.3892/ol.2019.10486] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 04/25/2019] [Indexed: 12/22/2022] Open
Abstract
Vascular endothelial growth factor (VEGF) is an important angiogenic factor. The VEGF rebound induced by hypoxia following transarterial embolization/chemoembolization for primary liver cancer is associated with treatment failure and poor survival rates in patients. The present study investigated the ability of intermittent hypoxia to alleviate the acute hypoxia-induced increase of VEGF and decrease the pro-angiogenic potential of liver cancer cells. The liver cancer cells were exposed to normoxia, or acute or intermittent hypoxia, and the expression of VEGF was determined using reverse transcription-quantitative polymerase chain reaction analysis and western blotting. The pro-angiogenic effects of acute or intermittent hypoxia-exposed liver cancer cells on endothelial cells were assessed in vitro and in vivo. The expression of VEGF in the liver cancer cells exposed to intermittent hypoxia was significantly lower than that in cells exposed to acute hypoxia. Compared with conditioned medium (CM) from acute hypoxia-exposed liver cancer cells, the CM from intermittent hypoxia-exposed liver cancer cells showed markedly less promotion of proliferation and tube formation in endothelial cells. Activation of the reactive oxygen species (ROS)/NF-κB/hypoxia-inducible factor-1α/VEGF signaling pathway was increased in the liver cancer cells exposed to acute hypoxia. Exposure to ROS scavenger N-acetyl-cysteine or NF-κB inhibitor PDTC inhibited the activation of the above pathway and the expression of VEGF induced by acute hypoxia. The in vivo pro-angiogenic effects of intermittent hypoxia-exposed liver cancer cells on endothelial cells were significantly reduced compared with those of acute hypoxia-exposed liver cancer cells. Intermittent hypoxia may alleviate the acute hypoxia-induced increase of VEGF and decrease the pro-angiogenic potential of liver cancer cells, suggesting a novel treatment strategy.
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Affiliation(s)
- Gang Dong
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Xia-Hui Lin
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Hua-Hua Liu
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Dong-Mei Gao
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Jie-Feng Cui
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Zheng-Gang Ren
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
| | - Rong-Xin Chen
- Liver Cancer Institute, Zhongshan Hospital, Fudan University and Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Shanghai 200032, P.R. China
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Flynn MJ, Sayed AA, Sharma R, Siddique A, Pinato DJ. Challenges and Opportunities in the Clinical Development of Immune Checkpoint Inhibitors for Hepatocellular Carcinoma. Hepatology 2019; 69:2258-2270. [PMID: 30382576 DOI: 10.1002/hep.30337] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/19/2018] [Indexed: 12/14/2022]
Abstract
After a decade of stagnation in drug development, therapeutic reversal of immune-exhaustion with immune checkpoint inhibitors (ICPIs) has been shown to be effective in advanced hepatocellular carcinoma (HCC). The clinical development of novel ICPIs continues at a rapid pace, with more than 50 clinical trials of immunotherapeutic agents registered as of May 2018 for this indication. The development of ICPI is particularly challenging in patients with HCC, a population with unique features which impact on safety and efficacy of immune-modulating therapies. In this review, we discuss the biological foundations supporting the development of ICPIs across the advancing stages of HCC, focusing on the rational positioning of ICPIs across the various Barcelona-Clinic Liver Cancer (BCLC) stages of the disease. Translational studies should guide adequate prioritization of those therapeutic agents and combination strategies which are most likely to achieve patient benefit based on solid mechanistic and clinical justifications.
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Affiliation(s)
- Michael J Flynn
- Department of Medicine, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Anwar A Sayed
- Centre for Haematology, Imperial College London, London, United Kingdom
- Department of Medical Microbiology and Immunology, Taibah University, Medina, Saudi Arabia
| | - Rohini Sharma
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - Abdul Siddique
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
| | - David J Pinato
- Department of Surgery & Cancer, Imperial College London, Hammersmith Hospital, London, United Kingdom
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A systematic review and meta-analysis of evaluation of serum interleukin 8 levels in hepatocellular carcinoma. Clin Exp Hepatol 2019; 5:123-128. [PMID: 31508492 PMCID: PMC6728862 DOI: 10.5114/ceh.2019.84780] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2018] [Accepted: 11/24/2018] [Indexed: 01/15/2023] Open
Abstract
Aim of the study To estimate serum interleukin 8 (IL-8) level in patients with hepatocellular carcinoma (HCC) compared to controls and patients with chronic hepatitis (CH) and liver cirrhosis (LC). Material and methods Three databases, i.e. PubMed, Web of Science, and Scopus, were searched up to November 2017 without language restriction. The mean difference (MD) and 95% confidence interval (CI) were used by a random-effects analysis in RevMan version 5.3, and sensitivity analysis was performed as the secondary analysis. Results Out of 239 studies found, 10 studies recruiting 659 HCC patients, 237 controls, 357 patients with LC, and 48 patients with CH were included and analyzed in the meta-analysis. The pooled MDs were 39.48 (95%CI: 152.31, 406.47, p < 0.00001), 21.32 (95% CI: –6.04, 48.68, p = 0.13), and 36.46 (95% CI: 21.77, 51.15, p < 0.00001) in the patients with HCC compared to the controls, the patients with LC and those with CH, respectively. Conclusions An elevated serum IL-8 level in the HCC patients compared to the three other groups showed an increased risk for this cytokine in HCC patients. Therefore, this interleukin can be used as a new biomarker replacing alpha-fetoprotein (AFP) or as a clinical assay for evaluation of the pathogenesis and probably the progression or development of HCC.
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Erinjeri JP, Fine GC, Adema GJ, Ahmed M, Chapiro J, den Brok M, Duran R, Hunt SJ, Johnson DT, Ricke J, Sze DY, Toskich BB, Wood BJ, Woodrum D, Goldberg SN. Immunotherapy and the Interventional Oncologist: Challenges and Opportunities-A Society of Interventional Oncology White Paper. Radiology 2019; 292:25-34. [PMID: 31012818 DOI: 10.1148/radiol.2019182326] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Interventional oncology is a subspecialty field of interventional radiology that addresses the diagnosis and treatment of cancer and cancer-related problems by using targeted minimally invasive procedures performed with image guidance. Immuno-oncology is an innovative area of cancer research and practice that seeks to help the patient's own immune system fight cancer. Both interventional oncology and immuno-oncology can potentially play a pivotal role in cancer management plans when used alongside medical, surgical, and radiation oncology in the care of cancer patients.
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Affiliation(s)
- Joseph P Erinjeri
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Gabriel C Fine
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Gosse J Adema
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Muneeb Ahmed
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Julius Chapiro
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Martijn den Brok
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Rafael Duran
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Stephen J Hunt
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - D Thor Johnson
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Jens Ricke
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Daniel Y Sze
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Beau Bosko Toskich
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - Bradford J Wood
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - David Woodrum
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
| | - S Nahum Goldberg
- From the Interventional Radiology Service, Memorial Sloan Kettering Cancer Center, 1275 York Ave, H-118, New York, NY 10065 (J.P.E.); Department of Radiology and Imaging Sciences, University of Utah School of Medicine, Salt Lake City, Utah (G.C.F.); Department of Radiation Oncology, Radboud University Medical Center, Nijmegen, the Netherlands (G.J.A., M.d.B.); Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass (M.A.); Division of Vascular and Interventional Radiology, Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (J.C.); Department of Radiodiagnostic and Interventional Radiology, University of Lausanne, Lausanne, Switzerland (R.D.); Penn Image-Guided Interventions Laboratory and Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pa (S.J.H.); Department of Radiology, University of Colorado, Denver, Colo (D.T.J.); Department of Radiology, Ludwig-Maximilian University, Munich, Germany (J.R.); Division of Vascular and Interventional Radiology, Stanford University, Stanford, Calif (D.Y.S.); Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, Fla (B.B.T.); Center for Interventional Oncology, National Cancer Institute, Radiology and Imaging Sciences, National Institutes of Health Clinical Center, Bethesda, Md (B.J.W.); Department of Radiology, Mayo Clinic, Rochester Minn (D.W.); and Department of Radiology, Hadassah Hebrew University Medical Center, Jerusalem, Israel (S.N.G.)
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He C, Zhang Y, Cai Z, Lin X. The prognostic and predictive value of the combination of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in patients with hepatocellular carcinoma who receive transarterial chemoembolization therapy. Cancer Manag Res 2019; 11:1391-1400. [PMID: 30863150 PMCID: PMC6388940 DOI: 10.2147/cmar.s190545] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Purpose This study was designed to evaluate the prognostic value of the combination of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (neutrophil/platelet-to-lymphocyte ratio [NLR–PLR]) in patients with hepatocellular carcinoma (HCC) who receive transarterial chemoembolization (TACE) therapy. Patients and methods Data from 216 patients who were diagnosed with HCC after TACE therapy were retrospectively collected. R software was used to analyze the time-dependent receiver operating characteristic (ROC) curves and to compare the area under the ROC curves (AUROCs). Results The long-term survival rates were significantly higher for patients with lower values than those with higher values of NLR, PLR, and NLR–PLR. The mean overall survival decreased gradually with increases in the NLR–PLR score (P<0.0001). The AUROC values of the NLR–PLR score were consistently higher than those of NLR and PLR. Conclusion This study showed that the NLR–PLR score might be a useful predictor for patients with HCC who receive TACE therapy.
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Affiliation(s)
- Chaobin He
- Department of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China,
| | - Yu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong, P. R. China
| | - Zhiyuan Cai
- Department of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China,
| | - Xiaojun Lin
- Department of Hepatobiliary and Pancreatic Surgery, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, P. R. China,
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23
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Petrillo M, Patella F, Pesapane F, Suter MB, Ierardi AM, Angileri SA, Floridi C, de Filippo M, Carrafiello G. Hypoxia and tumor angiogenesis in the era of hepatocellular carcinoma transarterial loco-regional treatments. Future Oncol 2018; 14:2957-2967. [DOI: 10.2217/fon-2017-0739] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
This review focuses upon interactions and potential therapeutic targets in the ‘vicious cycle’ between hypoxia and neoangiogenesis following treatment of hepatocellular carcinoma with transarterial loco-regional therapies. Biomarkers correlated with angiogenesis have been studied by many authors as prognostic determinants following transarterial intrahepatic therapy. According to these results future therapies directed toward specific factors related to angiogenesis could play a significant role in preventing local tumor recurrence and remote metastasis.
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Affiliation(s)
- Mario Petrillo
- Diagnostic & Interventional Radiology Service, San Paolo Hospital, Milan, Italy
| | - Francesca Patella
- Postgraduation School of Radiodiagnostic of Milan, Department of Health Sciences, Milan, Italy
| | - Filippo Pesapane
- Postgraduation School of Radiodiagnostic of Milan, Department of Health Sciences, Milan, Italy
| | - Matteo B Suter
- Department of Medical Oncology, ASST Sette laghi, Varese, Italy
| | - Anna M Ierardi
- Diagnostic & Interventional Radiology Service, San Paolo Hospital, Milan, Italy
| | | | - Chiara Floridi
- Department of Diagnostic & Interventional Radiology Fatebenefratelli Hospital, Milan, Italy
| | - Massimo de Filippo
- Department of Medicine & Surgery Via Gramsci Azienda Ospedaliero Universitaria di Parma, 14 Parma, Italy
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24
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Shakiba E, Ramezani M, Sadeghi M. Evaluation of serum interleukin-6 levels in hepatocellular carcinoma patients: a systematic review and meta-analysis. Clin Exp Hepatol 2018; 4:182-190. [PMID: 30324143 PMCID: PMC6185933 DOI: 10.5114/ceh.2018.78122] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 12/26/2017] [Indexed: 02/07/2023] Open
Abstract
AIM OF THE STUDY This meta-analysis evaluated serum interleukin-6 (IL-6) levels in hepatocellular carcinoma (HCC) patients compared with healthy controls and hepatitis and cirrhotic patients. MATERIAL AND METHODS The three databases PubMed, Scopus, and Web of Science were searched for assessment of IL-6 levels in HCC patients (without cirrhosis and hepatitis) compared with healthy controls (without HCC, cirrhosis and hepatitis) and the studies were selected based on inclusion and exclusion criteria. A random-effect meta-analysis was performed with RevMan 5.3 software, using mean difference (MD) and 95% confidence intervals (CIs). RESULTS Out of 503 studies searched in databases, 18 studies were included in the meta-analysis. The pooled analysis with continuous data demonstrated that the IL-6 level in HCC patients was significantly higher than that in healthy controls (MD = 12.44; 95% CI: 9.02-15.85; p < 0.00001). Also, the pooled analysis demonstrated that the IL-6 levels in cirrhotic patients (MD = -6.98; 95% CI: -12.91-1.05; p < 0.02) and patients with hepatitis (MD = -8.43; 95% CI: -11.91-4.95; p < 0.00001) were significantly lower than the level in HCC patients, and the subgroup analyses had high heterogeneity. CONCLUSIONS The elevated IL-6 levels in HCC patients compared with hepatitis and cirrhosis patients and healthy controls may show a significant association of this cytokine with increased risk of HCC and its potential as a diagnostic marker for HCC in future diagnostic and therapeutic strategies.
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Affiliation(s)
- Ebrahim Shakiba
- Department of Clinical Biochemistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mazaher Ramezani
- Molecular Pathology Research Center, Emam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Sadeghi
- Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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25
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Peng L, Yuan XQ, Zhang CY, Ye F, Zhou HF, Li WL, Liu ZY, Zhang YQ, Pan X, Li GC. High TGF-β1 expression predicts poor disease prognosis in hepatocellular carcinoma patients. Oncotarget 2018; 8:34387-34397. [PMID: 28415739 PMCID: PMC5470976 DOI: 10.18632/oncotarget.16166] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 03/04/2017] [Indexed: 12/16/2022] Open
Abstract
Transforming growth factor beta (TGF-β) promotes the pathogenesis of hepatocellular carcinoma (HCC). We evaluated the associations between TGF-β1 expression and clinicopathological parameters in HCC patients from The Cancer Genome Atlas (TCGA), as well as the prognostic power of TGF-β1 expression. Eligible studies were retrieved from several databases, and effects (hazard ratios (HRs) with 95% confidence intervals (CIs)) for overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), metastasis-free survival (MFS), and progression-free survival (PFS) were pooled to assess the prognostic ability of TGF-β1 expression in HCC patients. Twelve qualified articles and our TCGA data comprising 2,021 HCC patients were incorporated. In the TCGA analysis, HCC patients with higher TGF-β1 expression presented a shorter OS than those with lower TGF-β1 expression (HR = 1.42, p < 0.05). In the meta-analysis, univariate analyses showed that HCC patients with higher TGF-β1 expression had a shorter OS (pooling HR = 1.71, p < 0.01) and DFS/RFS/MFS/PFS (pooling HR = 1.60, p < 0.01) than those with lower TGF-β1 expression. In conclusion, our results suggested that high TGF-β1 expression promotes a poor prognosis in HCC patients.
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Affiliation(s)
- Li Peng
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
| | - Xiao-Qing Yuan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha 410008, P.R. China.,Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha 410078, P.R. China
| | - Chao-Yang Zhang
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
| | - Fei Ye
- Department of Cardiology, the Third Xiangya Hospital, Central South University, Changsha 410100, P.R. China
| | - Hui-Fang Zhou
- Department of Physiology, Changsha Health Vocational College, Changsha 410100, P.R. China
| | - Wen-Ling Li
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
| | - Zhao-Yang Liu
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
| | - Ya-Qin Zhang
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
| | - Xi Pan
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China.,Department of Oncology, the third Xiangya Hospital, Central South University, Changsha 410013, P.R. China
| | - Guan-Cheng Li
- Key Laboratory of Carcinogenesis of the Chinese Ministry of Health and the Key Laboratory of Carcinogenesis and Cancer Invasion of Chinese Ministry of Education, Xiangya Hospital, Central South University, Changsha 410078, P.R. China.,Cancer Research Institute, Central South University, Changsha 410078, P.R. China
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26
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The Potential of Angiogenin as a Serum Biomarker for Diseases: Systematic Review and Meta-Analysis. DISEASE MARKERS 2018; 2018:1984718. [PMID: 29736193 PMCID: PMC5875026 DOI: 10.1155/2018/1984718] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 01/02/2018] [Accepted: 01/11/2018] [Indexed: 12/19/2022]
Abstract
Background Angiogenin (ANG) is a multifunctional angiogenic protein that participates in both normal development and diseases. Abnormal serum ANG levels are commonly reported in various diseases. However, whether ANG can serve as a diagnostic or prognostic marker for different diseases remains a matter of debate. Methods Here, we performed a systematic review and meta-analysis of the literature utilizing PubMed, Web of Science, and Scopus search engines to identify all publications comparing plasma or serum ANG levels between patients with different diseases and healthy controls, as were studies evaluating circulating ANG levels in healthy populations, pregnant women, or other demographic populations. Results This study demonstrated that the serum ANG concentration in healthy populations was 336.14 ± 142.83 ng/ml and remained relatively stable in different populations and regions. We noted no significant differences in serum ANG levels between patients and healthy controls, except in cases in which patients suffered from cancer or cardiovascular diseases. The serum ANG concentrations were significantly higher in patients who developed colorectal cancer, acute myeloid leukemia, multiple myeloma, myelodysplastic syndromes, and heart failure than those in healthy controls. Conclusion ANG has the potential of being a serum biomarker for cancers and cardiovascular diseases.
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27
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Lee TY, Lin CC, Chen CY, Wang TE, Lo GH, Chang CS, Chao Y. Combination of transcatheter arterial chemoembolization and interrupted dosing sorafenib improves patient survival in early-intermediate stage hepatocellular carcinoma: A post hoc analysis of the START trial. Medicine (Baltimore) 2017; 96:e7655. [PMID: 28906355 PMCID: PMC5604624 DOI: 10.1097/md.0000000000007655] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND/OBJECTIVE The survival benefit of treatment for unresectable hepatocellular carcinoma (HCC) with transcatheter arterial chemoembolization (TACE) combined with sorafenib remains uncertain. We compared the survival of patients treated with TACE and sorafenib with that of patients treated with TACE alone. METHODS This was a post hoc analysis of the Study in Asia of the Combination of TACE with Sorafenib in Patients with HCC (START) trial. All patients who received TACE and interrupted dosing of sorafenib for early or intermediate-stage HCC in Taiwan from 2009 to 2010 were recruited into the TACE and sorafenib group. They were randomly matched 1:1 by age, sex, Child-Pugh score, tumor size, tumor number, and tumor stage with patients from Taichung Veterans General Hospital in Taiwan who received TACE alone and who fulfilled the selection criteria of the START trial during the same time period (control group). Patient survival [cumulative incidence and hazard ratio (HR)] of the 2 groups were analyzed and compared. RESULTS The baseline characteristics of the 36 patients in each group were similar. Tumor response rates were significantly better in the TACE and sorafenib group (P < .04). Overall survival of the TACE and sorafenib group was also significantly better than that of the control (TACE alone) group over the 2 years [78%, 95% confidence interval (95% CI) 64-91 vs 49, 95% CI 32-66; P = .012]. In the multivariate regression analysis, TACE and sorafenib was found to be independently associated with a decreased risk of mortality (HR 0.33, 95% CI 0.12-0.89; P = .015). Multivariate stratified analyses verified this association in each patient subgroup (all HR < 1.0). CONCLUSION With a high patient tolerance to an interrupted sorafenib dosing schedule, the combination of TACE with sorafenib was associated with improved overall survival in early-intermediate stage HCC when compared with treatment with TACE alone.
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Affiliation(s)
- Teng-Yu Lee
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital
- Department of Medicine, Chung Shan Medical University, Taichung
| | - Chen-Chun Lin
- Division of Hepatology, Liver Research Unit, Department of Gastroenterology and Hepatology, Linkou Chang Gung Memorial Hospital–Chang Gung University, Linkou
| | - Chiung-Yu Chen
- National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan
| | | | - Gin-Ho Lo
- Department of Medical Research, E-Da Hospital, School of Medicine for International Students, I-Shou University, Kaohsiung
| | - Chi-Sen Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taichung Veterans General Hospital
| | - Yee Chao
- Department of Oncology, Taipei Veterans General Hospital, National Yang-Ming University, Taipei, Taiwan
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28
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Ronald J, Nixon AB, Marin D, Gupta RT, Janas G, Chen W, Suhocki PV, Pabon-Ramos W, Sopko DR, Starr MD, Brady JC, Hurwitz HI, Kim CY. Pilot Evaluation of Angiogenesis Signaling Factor Response after Transcatheter Arterial Embolization for Hepatocellular Carcinoma. Radiology 2017; 285:311-318. [PMID: 28787261 DOI: 10.1148/radiol.2017162555] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Purpose To identify changes in a broad panel of circulating angiogenesis factors after bland transcatheter arterial embolization (TAE), a purely ischemic treatment for hepatocellular carcinoma (HCC). Materials and Methods This prospective HIPAA-compliant study was approved by the institutional review board. Informed written consent was obtained from all participants prior to entry into the study. Twenty-five patients (21 men; mean age, 61 years; range, 30-81 years) with Liver Imaging Reporting and Data System category 5 or biopsy-proven HCC and who were undergoing TAE were enrolled from October 15, 2014, through December 2, 2015. Nineteen plasma angiogenesis factors (angiopoietin 2; hepatocyte growth factor; platelet-derived growth factor AA and BB; placental growth factor; vascular endothelial growth factor A and D; vascular endothelial growth factor receptor 1, 2, and 3; osteopontin; transforming growth factor β1 and β2; thrombospondin 2; intercellular adhesion molecule 1; interleukin 6 [IL-6]; stromal cell-derived factor 1; tissue inhibitor of metalloproteinases 1; and vascular cell adhesion molecule 1 [VCAM-1]) were measured by using enzyme-linked immunosorbent assays at 1 day, 2 weeks, and 5 weeks after TAE and were compared with baseline levels by using paired Wilcoxon tests. Tumor response was assessed according to modified Response Evaluation Criteria in Solid Tumors (mRECIST). Angiogenesis factor levels were compared between responders and nonresponders by mRECIST criteria by using unpaired Wilcoxon tests. Results All procedures were technically successful with no complications. Fourteen angiogenesis factors showed statistically significant changes following TAE, but most changes were transient. IL-6 was upregulated only 1 day after the procedure, but showed the largest increases of any factor. Osteopontin and VCAM-1 demonstrated sustained upregulation at all time points following TAE. At 3-month follow-up imaging, 11 patients had responses to TAE (complete response, n = 6; partial response, n = 5) and 11 patients were nonresponders (stable disease, n = 9; progressive disease, n = 2). In nonresponders, the percent change in IL-6 on the day after TAE (P = .033) and the mean percent change in osteopontin after TAE (P = .024) were significantly greater compared with those of responders. Conclusion Multiple angiogenesis factors demonstrated significant upregulation after TAE. VCAM-1 and osteopontin demonstrated sustained upregulation, whereas the rest were transient. IL-6 and osteopontin correlated significantly with radiologic response after TAE. © RSNA, 2017.
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Affiliation(s)
- James Ronald
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Andrew B Nixon
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Daniele Marin
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Rajan T Gupta
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Gemini Janas
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Willa Chen
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Paul V Suhocki
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Waleska Pabon-Ramos
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - David R Sopko
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Mark D Starr
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - John C Brady
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Herbert I Hurwitz
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
| | - Charles Y Kim
- From the Department of Radiology, Division of Vascular & Interventional Radiology (J.R., D.M., R.T.G., G.J., W.C., P.V.S., W.P.R., D.R.S., C.Y.K.), and Department of Medicine (A.B.N., M.D.S., J.C.B., H.I.H.), Duke University Medical Center, Box 3808 Duke University Medical Center, 2301 Erwin Road, Durham, NC 27710
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Cha H, Lee EJ, Seong J. Multi-analyte analysis of cytokines that predict outcomes in patients with hepatocellular carcinoma treated with radiotherapy. World J Gastroenterol 2017; 23:2077-2085. [PMID: 28373775 PMCID: PMC5360650 DOI: 10.3748/wjg.v23.i11.2077] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 12/26/2016] [Accepted: 01/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To analyze cytokine levels and to identify their association with outcome in patients with hepatocellular carcinoma (HCC) treated with radiotherapy (RT).
METHODS Patients with HCC who were treated with RT were eligible for this prospective study. Blood samples were collected before and after RT, and serum cytokine levels including interleukin (IL)-1, IL-6, IL-8, IL-10, IL-12, and tumor necrosis factor-α were analyzed.
RESULTS Between 2008 and 2009, 51 patients were enrolled in this study. Baseline IL-6 level was high in patients with a history of pre-RT treatment. Median survival was 13.9 mo with alpha-fetoprotein (AFP) as a significant factor (P = 0.020). Median failure-free survival (FFS) for infield, outfield-intrahepatic and extrahepatic failures were 23.3, 11.5 and 12.0 mo, respectively. Sex and baseline IL-6 level were associated with infield FFS, and baseline IL-10 level was correlated with outfield-intrahepatic FFS. For extrahepatic FFS, AFP was significant (P = 0.034). Patients with a baseline IL-6 level of ≥ 9.7 pg/mL showed worse infield FFS (P = 0.005), and this significance was observed only in treatment-non-naïve patients (P = 0.022).
CONCLUSION In addition to AFP, cytokines seem useful in predicting infield and outfield-intrahepatic failure. Serum cytokines could be useful biomarkers for predicting RT outcome in HCC.
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30
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Liu K, Min XL, Peng J, Yang K, Yang L, Zhang XM. The Changes of HIF-1α and VEGF Expression After TACE in Patients With Hepatocellular Carcinoma. J Clin Med Res 2016; 8:297-302. [PMID: 26985249 PMCID: PMC4780492 DOI: 10.14740/jocmr2496w] [Citation(s) in RCA: 82] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 02/05/2023] Open
Abstract
As a common malignant tumor, hepatocellular carcinoma (HCC) has a high prevalence and is a serious threat to human health. The surgical resection rate of HCC is low, and the prognosis is poor. Although transarterial chemoembolization (TACE) is the main treatment for HCC patients who are not candidates for surgical resection, it is not considered a curative procedure. For HCC, poor TACE efficacy or TACE failure may be related to tumor angiogenesis of the residual disease. Among the many regulatory factors in tumor angiogenesis, hypoxia-inducible factor-1α (HIF-1α) and vascular endothelial growth factor (VEGF) play vital roles in this process. In this paper, we conducted a review of the dynamic change and relevance of HIF-1α and VEGF levels after TACE of HCC patients.
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Affiliation(s)
- Kang Liu
- Department of Pain Management, Xianyang Hospital, Yan'an University, Xianyang, Shanxi 712000, China; Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Xu-Li Min
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Juan Peng
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Ke Yang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Lin Yang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
| | - Xiao-Ming Zhang
- Department of Radiology, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan 637000, China
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31
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Gelu-Simeon M, Samuel D. Role of cytokine levels in assessment of prognosis and post-treatment outcome in hepatocellular carcinoma. Hepatol Int 2013. [PMID: 26201913 DOI: 10.1007/s12072-013-9441-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Moana Gelu-Simeon
- AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 94800, Villejuif, France.
| | - Didier Samuel
- AP-HP Hôpital Paul Brousse, Centre Hépato-Biliaire, 94800, Villejuif, France. .,INSERM, U785, 94800, Villejuif, France. .,Faculté de Médecine, Université Paris-Sud, 94270, Le Kremlin-Bicêtre, France.
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