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Liu S, Liu C, Wang Q, Liu Y, Wang D, Zhao G, Yu G. The second-line treatment of hepatocellular carcinoma with CalliSpheres drug-eluting bead transarterial chemoembolization combined with regorafenib: A safety and efficacy analysis. Ir J Med Sci 2024; 193:1215-1222. [PMID: 38300460 DOI: 10.1007/s11845-024-03611-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/12/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND This study aimed to investigate the efficacy and safety of CalliSpheres drug-eluting beads transarterial chemoembolization (DEB-TACE) combined with regorafenib in the second-line treatment of unresectable hepatocellular carcinoma. METHODS A retrospective analysis was made of 34 patients with unresectable hepatocellular carcinoma (HCC) that had progressed after first-line treatment in Linyi Tumor Hospital from October 2019 to June 2021. These patients were divided into observation group (n = 15) and control group (n = 19) based on their treatment plans, who were respectively treated with regorafenib alone and regorafenib combined with DEB-TACE. The objective response rate (ORR) and the disease control rate (DCR) were evaluated by the modified Response Evaluation Criteria in Solid Tumors (mRECIST), and the progression-free survival (PFS) and the overall survival (OS) were calculated; the factors influencing PFS and OS of patients were analyzed by the Cox proportional hazards model; and the adverse reactions to the treatments were observed and recorded. RESULTS After 2 months of treatment, the ORR and the DCR of the observation group were 73.3% (11/15) and 86.7% (13/15) respectively, both higher than 10.5% (2/19) and 47.4% (9/19) of the control group. Their differences are statistically significant (P < 0.05). There were no statistically significant differences in the incidences of regorafenib-related adverse reactions including hand-foot skin reactions, fatigue, hypertension, diarrhea, and proteinuria between the two groups (P > 0.05). In the observation group, the main adverse reactions to DEB-TACE such as fever, pain, nausea, and vomiting were relieved after symptomatic treatment, and no serious complications such as ectopic embolization of CalliSpheres drug-eluting beads occurred. As of July 31, 2022, the median follow-up time was 12.5 months, and the average was (14.00 ± 5.69) months. The median PFS was 9 months in the observation group, and 6 months in the control group, presenting a statistically significant difference (P < 0.05), and the median OS was 18 months in the observation group, and 12 months in the control group, also presenting a statistically significant difference (P < 0.05). The results of monofactor prognostic analysis showed that Child grade, AFP level, and treatment method had an influence on the PFS and the OS of liver cancer patients receiving regorafenib second-line treatment (P < 0.05), and the results of multifactor prognostic analysis showed that child grade and treatment method independently influenced the PFS of patients, while treatment method independently influenced the OS of patients (P < 0.05). CONCLUSIONS DEB-TACE combined with regorafenib is safe and feasible in the treatment of unresectable HCC, with good efficacy and mild adverse reactions.
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Affiliation(s)
- Song Liu
- Dalian Medical University, No.9 Western Section, Lvshun South Street, Lvshun District, Dalian, 116044, Liaoning Province, China
- Department of Interventional Therapy, Linyi Cancer Hospital, No. 6 East Lingyuan Street, Linyi, 276000, Shandong Province, China
| | - Changqing Liu
- Dalian Medical University, No.9 Western Section, Lvshun South Street, Lvshun District, Dalian, 116044, Liaoning Province, China
- Department of General Surgery, Dalian Municipal Central Hospital, No. 826 Southwest Road, Shahekou District, Dalian, 116089, Liaoning Province, China
| | - Qingdong Wang
- Department of Interventional Therapy, Linyi Cancer Hospital, No. 6 East Lingyuan Street, Linyi, 276000, Shandong Province, China
| | - Ying Liu
- Hepatobiliary and Pancreatic Center, Beijing Tsinghua Chang geng Hospital, Changping District, Beijing, 102218, China
| | - Dong Wang
- Dalian Medical University, No.9 Western Section, Lvshun South Street, Lvshun District, Dalian, 116044, Liaoning Province, China.
- Department of General Surgery, Dalian Municipal Central Hospital, No. 826 Southwest Road, Shahekou District, Dalian, 116089, Liaoning Province, China.
| | - Guangsheng Zhao
- Minimally Invasive Interventional Diagnosis and Treatment Center, Affiliated Zhongshan Hospital of Dalian University, No.6 JieFang Street, Zhongshan District, Dalian, 116001, Liaoning Province, China.
| | - Guangji Yu
- Department of Interventional Therapy, Linyi Cancer Hospital, No. 6 East Lingyuan Street, Linyi, 276000, Shandong Province, China.
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Wu K, Ma S, Xu X, Liu Y, Tian C, Zhang C, Shan J, Li Z, Ren K, Ren J, Han X, Zhao Y. Celecoxib and cisplatin dual-loaded microspheres synergistically enhance transarterial chemoembolization effect of hepatocellular carcinoma. Mater Today Bio 2024; 24:100927. [PMID: 38234462 PMCID: PMC10792487 DOI: 10.1016/j.mtbio.2023.100927] [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: 09/25/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/19/2024] Open
Abstract
Transarterial chemoembolization (TACE) is a first-line treatment for intermediate to advanced-stage liver cancer, with drug-eluting microspheres commonly used as embolic agents. However, currently available drug-eluting microspheres suffer from low drug-loading capacity and limited drug options. In this work, we developed polydopamine-modified polyvinyl alcohol dual-drug-loaded microspheres encapsulating celecoxib and cisplatin (referred to as PCDMS). Physicochemical characterization revealed that the surface of the microspheres displayed increased roughness after polydopamine modification, and celecoxib and cisplatin were successfully loaded onto the microsphere surface. In vitro cell experiments demonstrated that the PCDMS significantly inhibited the proliferation and migration of highly metastatic human liver cancer cells (MHCC-97H) and human liver cancer cells (SMMC-7721). Furthermore, the dual-loaded microspheres exhibited remarkable tumor growth inhibition and reshaped the tumor microenvironment in both subcutaneous H22 liver cancer model in Balb/c mice and intrahepatic VX2 tumor model in New Zealand rabbits, demonstrating a synergistic antitumor effect where 1 + 1>2. This work provides a potential therapeutic approach for the treatment of refractory liver cancer and holds significant translational potential.
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Affiliation(s)
- Kunpeng Wu
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Shengnan Ma
- Department of Endocrinology and Metabolism, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, 450052, Henan, China
| | - Xiaohong Xu
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Yiming Liu
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Chuan Tian
- Department of Interventional Medical Center, the Affiliated Hospital of Qingdao University, No. 1677 Wutaishan Road, Shandong, 266000, Qingdao, China
| | - Chengzhi Zhang
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Jiheng Shan
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Zongming Li
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Kewei Ren
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Jianzhuang Ren
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Xinwei Han
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
| | - Yanan Zhao
- Department of Interventional Radiology, Key Laboratory of Interventional Radiology of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Institute of Zhengzhou University, Zhengzhou, 450052, China
- Interventional Treatment and Clinical Research Center of Henan Province, Zhengzhou, 450052, China
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Zhou C, Peng C, Liu F, Xiao J, Li G, Chen C, Shi L, Li H. Evaluation of the efficacy and safety of CalliSpheres® microsphere-transarterial chemoembolization in large hepatocellular carcinoma. J Cancer Res Ther 2023; 19:1575-1581. [PMID: 38156924 DOI: 10.4103/jcrt.jcrt_218_23] [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: 02/01/2023] [Accepted: 07/31/2023] [Indexed: 01/03/2024]
Abstract
OBJECTIVE The prognosis of large hepatocellular carcinoma (HCC) is still unfavorable due to limited and challenging treatment. CalliSpheres® microsphere-transarterial chemoembolization (CSM-TACE) is an effective therapy for general HCC but not frequently applied for large HCC. Hence, this study aimed to investigate the efficacy and safety of CSM-TACE in large HCC patients. MATERIALS AND METHODS This prospective study analyzed 100 large HCC (tumor size >5 cm) patients receiving CSM-TACE. Treatment response, survival, change in liver function indexes, and adverse events were recorded. RESULT The best complete response, partial response, stable disease, and progressive disease rates were 2.0%, 31.3%, 65.7%, and 1.0%, respectively, leading to the best objective response rate (ORR) of 33.3% and disease control rate of 99.9%. Multivariate analysis showed that intrahepatic metastasis was independently related to poor ORR (odd ratio = 0.366, P = 0.023). The 1- and 2-year progression-free survival (PFS) rates were 88.9% and 80.6%, with a mean [95% confidence interval (CI)] PFS of 21.6 (20.4-22.9) months. The 1- and 2-year overall survival (OS) rates were 99.0% and 99.0%, with a mean (95% CI) OS of 23.8 (23.3-24.2) months. Total bilirubin (P < 0.001), alanine transaminase (P < 0.001), aspartate transaminase (P < 0.001), and α-fetoprotein (P = 0.045) were abnormal in a short-term period then stably recovered from 1 month ± 15 days after drug-eluting bead-TACE to 24 months ± 15 days. During hospitalization and postdischarge, tolerable abdominal pain and decreased appetite were common adverse events. CONCLUSIONS CSM-TACE shows favorable treatment response and survival with acceptable tolerance among large HCC patients, indicating that it may promote the management of these patients.
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Affiliation(s)
- Chunhui Zhou
- Department of Radiology, Radiological Intervention Center, Xiangya Hospital, Central South University, Changsha, Hunan, China
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Zhao GS, Song YX, Sun JB, Liu S, Xu F, Ma J, Li C, Gao F, Zhou J, Wang RY, Liang SN. Efficacy and safety of CalliSpheres® microspheres drug-eluting beads transarterial chemoembolization in GCLM combined trans-arterial infusion therapy for treating primary focus of gastric cancer: a multi-center retrospective study. Expert Rev Anticancer Ther 2023; 23:1009-1016. [PMID: 37475534 DOI: 10.1080/14737140.2023.2239496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/01/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND The purpose of this study was to observe the safety and efficacy of CalliSpheres microspheres drug-eluting beads (DEB) transhepatic arterial chemoembolization (CSM-TACE) for liver metastasis of gastric cancer (GCLM) combined with trans-arterial infusion therapy (TAIT) as the primary focus of gastric cancer. RESEARCH DESIGN AND METHODS Unresectable advanced GCLM patients were collected for retrospective analysis. Patients who progressed after chemotherapy or could not receive systematic chemotherapy were selected. CSM-TACE was used for GCLM treatment and oxaliplatin for TAIT of primary focus of gastric cancer. Adverse reactions, tumor reactions, survival rate, and survival time during treatment were recorded, and prognostic factors were analyzed. RESULTS Forty-three patients from four oncology centers met inclusion criteria and were enrolled. CSM-TACE averaged (1.51 ± 0.51) times and TAIT averaged (4.58 ± 1.65) times. The follow-up time was 2.5-49 months, and the 6-month, 1-year, and 2-year survival rates were 86.0%, 72.1%, and 41.9%, respectively, with a median overall survival of 11.5 months. The adverse reactions during treatment were grade 1-3. The hazard ratio (HR) of combination therapy was 0.51 (P = 0.040), and the HR of TAIT frequency was 0.34 (P = 0.002), which were independent protective factors affecting prognosis. CONCLUSIONS CSM-TAC for GCLM combined with TAIT for primary focus of gastric cancer is safe and efficacious, which is worthy of clinical promotion and application.
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Affiliation(s)
- Guang Sheng Zhao
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Yu Xin Song
- Department of Intervention, Chifeng Municipal Hospital, Chifeng, Mongolia Autonomous Region, China
| | - Jin Bo Sun
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Song Liu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, Shandong Province, China
| | - Fang Xu
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Jian Ma
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Chuang Li
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Fei Gao
- Cancer Interventional Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province, China
| | - Jun Zhou
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Ruo Yu Wang
- Department of Cancer Treatment Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
| | - Song Nian Liang
- Department of Interventional Radiology, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
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Wang J, Xu H, Wang Y, Feng L, Yi F. Efficacy and Safety of Drug-Eluting Bead TACE in the Treatment of Primary or Secondary Liver Cancer. Can J Gastroenterol Hepatol 2023; 2023:5492931. [PMID: 37153689 PMCID: PMC10156455 DOI: 10.1155/2023/5492931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 04/16/2023] [Accepted: 04/18/2023] [Indexed: 05/10/2023] Open
Abstract
Background The drug-eluting beads transarterial chemoembolization (DEB-TACE) has already been used in hepatic malignancies. We aim to evaluate the efficacy and safety of DEB-TACE in treating primary or secondary liver cancer. Methods We retrospectively evaluated 59 patients with hepatic malignancies, including 41 patients with primary liver cancer and 18 patients with secondary liver cancer, between September 2016 and February 2019. All patients were treated with DEB-TACE. Objective response rate (ORR) and disease control rate (DCR) were evaluated by mRECIST. The pain was assessed using a numerical rating scale (NRS) where 0 represented no pain, and a score of ten was unbearable. Adverse reactions were assessed according to Common Terminology Criteria for Adverse Events 4.0 (CTCAE4.0). Results In the subgroup of primary liver cancer, 3 patients (7.32%) got complete response, 13 patients (31.71%) got partial response, 21 patients (51.22%) experienced stable disease, and 4 patients (9.76%) suffered progressive disease; ORR was 39.02% and DCR was 90.24%. In the subgroup of secondary liver cancer, 0 patients (0%) got complete response, 6 patients (33.33%) got partial response, 11 patients (61.11%) experienced stable disease, and 1 patient (5.56%) suffered progressive disease; ORR was 33.33% and DCR was 94.44%. We did not find any difference when comparing the efficacy between primary and secondary liver cancer (P=0.612). The one-year survival rate was 70.73% for primary liver cancer and 61.11% for secondary liver cancer. There was no significant difference between the two groups (P=0.52). For the patients with CR or PR, no factor could predict the efficacy of DEB-TACE. The most common treatment-related adverse reactions were short-term liver function disorders. The symptoms included fever (20.34%), abdomen pain (16.95%), and vomiting (5.08%), all patients with adverse reactions got remission after treatment. Conclusions DEB-TACE has a promising effect in the treatment of primary or secondary liver cancer. The treatment-related adverse reactions are tolerable.
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Affiliation(s)
- Jiabing Wang
- Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang 330006, China
- Jiangxi Provincial People's Hospital, Nanchang 330006, China
| | - Haoqian Xu
- Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang 330006, China
| | - Ying Wang
- Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang 330006, China
| | - Long Feng
- Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang 330006, China
| | - Fengming Yi
- Department of Oncology, Second Affiliated Hospital of Nanchang University, Nanchang 330006, China
- Jiangxi Key Laboratory of Clinical and Translational Cancer Research, Nanchang 330006, China
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Zhao YW, Liu S, Qin H, Sun JB, Su M, Yu GJ, Zhou J, Gao F, Wang RY, Zhao T, Zhao GS. Efficacy and safety of CalliSpheres drug-eluting beads for bronchial arterial chemoembolization for refractory non-small-cell lung cancer and its impact on quality of life: A multicenter prospective study. Front Oncol 2023; 13:1110917. [PMID: 37124525 PMCID: PMC10141642 DOI: 10.3389/fonc.2023.1110917] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/27/2023] [Indexed: 05/02/2023] Open
Abstract
Objective This study aimed to prospectively observe the efficacy and safety of CalliSpheres drug-eluting beads bronchial arterial chemoembolization (DEB-BACE) for refractory non-small-cell lung cancer (NSCLC). Methods The interventional therapy plan was as follows: 300-500 μm CalliSpheres drug-loaded microspheres were loaded with epirubicin, and then slow embolization of tumor supplying artery was performed after microcatheter superselection. Chest enhanced computed tomography and related hematological examination were reviewed after 2 months of DEB-BACE, and the tumor response after the first interventional therapy was evaluated using modified response evaluation criteria in solid tumors. The overall survival (OS) of patients was determined, and the quality of life and the incidence rate of adverse reactions were observed. Results From January 2019 to January 2021, 43 patients with refractory NSCLC were enrolled. The patients were followed up until June 2022. All 43 patients underwent DEB-BACE 1.79 ± 0.69 times on average. The 3-, 6-, 12-, and 24-month survival rates were 100%, 86.0%, 41.9%, and 11.8%, respectively. The median OS was 11.5 months. After the first interventional treatment, cough and wheezing significantly improved in 31 patients, hemoptysis was effectively controlled in 12 patients, and superior vena cava compression disappeared in 2 patients after 2 times of treatment. The general health status of the patients after treatment significantly improved compared with that before treatment, including the improvement in physical and emotional functions. Fatigue, nausea and vomiting, dyspnea, and insomnia improved significantly after treatment. No serious adverse events, such as spinal cord injury and cerebral embolism, were observed during the perioperative period. The main adverse reaction after DEB-BACE was chest pain (13/43, grade 1) followed by fever (10/43, grade 1-2), which was significantly relieved within 3-5 days after symptomatic treatment. Other adverse reactions included irritating cough, nausea and vomiting, and bone marrow suppression, and the incidence was less than 20%. Conclusions DEB-BACE was effective and safe in treating refractory NSCLC, which could significantly improve patients' quality of life and was worthy of clinical promotion and application.
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Affiliation(s)
- Yu Wei Zhao
- Department of Oncology, Affiliated Zhongshan Hospital of Dalian Universtity, Dalian, Liaoning, China
| | - Song Liu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, Shandong, China
| | - Hao Qin
- Department of Emergency Surgery, Affiliated Zhongshan Hospital of Dalian Universtity, Dalian, Liaoning, China
| | - Jin Bo Sun
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Mao Su
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Guang Ji Yu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, Shandong, China
| | - Jun Zhou
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
| | - Fei Gao
- Cancer Interventional Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Ruo Yu Wang
- Department of Oncology, Affiliated Zhongshan Hospital of Dalian Universtity, Dalian, Liaoning, China
- *Correspondence: Guang Sheng Zhao, ; Tong Zhao, ; Ruo Yu Wang,
| | - Tong Zhao
- Department of Oncology, Affiliated Zhongshan Hospital of Dalian Universtity, Dalian, Liaoning, China
- *Correspondence: Guang Sheng Zhao, ; Tong Zhao, ; Ruo Yu Wang,
| | - Guang Sheng Zhao
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning, China
- *Correspondence: Guang Sheng Zhao, ; Tong Zhao, ; Ruo Yu Wang,
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Zhou J, Feng Z, Liu S, Li X, Liu Y, Gao F, Shen J, Zhang YW, Zhao GS, Zhang M. Simultaneous CSM‐TACE with CalliSpheres® and partial splenic embolization using 8spheres® for hepatocellular carcinoma with hypersplenism: Early prospective multicenter clinical outcome. Front Oncol 2022; 12:998500. [DOI: 10.3389/fonc.2022.998500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
BackgroundPrimary hepatocellular carcinoma is often complicated with hepatitis and liver cirrhosis. Some patients develop different degrees of splenomegaly, hypersplenism and hypohepatia due to the aggravation of liver cirrhosis, which to some extent interfere with the treatment of tumors and even affect the prognosis of patients. In this study, we prospectively evaluate the efficacy and safety of simultaneous CalliSpheres® microspheres transcatheter arterial chemoembolization (CSM-TACE) and partial splenic embolization (PSE) using 8spheres® for hepatocellular carcinoma (HCC) with hypersplenism.MethodsNinety consecutive HCC patients with hypersplenism who underwent CSM-TACE were selected: 32 patients in CSM-TACE+PSE group, and 58 patients in CSM-TACE group. The peripheral blood cell counts (leukocyte, platelet (PLT), liver function and red blood cell (RBC)), CSM-TACE and/or PSE related complications, and the tumor control rate at 1 month after CSM-TACE were compared. The survival time and prognostic factors were also observed.ResultsBefore CSM-TACE, there were no significant differences in sex, age, Child-Pugh grade, tumor size, and alpha-fetoprotein (AFP) between the two groups. After CSM-TACE, the PLT and white blood cell (WBC) counts in CSM-TACE+PSE group were significantly higher than those in the CSM-TACE group (P<0.05). There were no significant differences in RBC before and after treatment (P > 0.05). In the CSM-TACE group, there were no significant differences in WBC, PLT, and RBC before and after treatment (P > 0.05). There was no significant difference in liver function at 1 month after treatment between the two groups. The cholinesterase (CHE) level in the CSM-TACE+PSE group after CSM-TACE+PSE was obviously higher than that before CSM-TACE+PSE and higher than that in the CSM-TACE group (P<0.05). However, the level of CHE returned to the preoperative level 1 month after CSM-TACE in the CSM-TACE group. The objective response rate (ORR) and median overall survival (OS) in the CSM-TACE+PSE group were higher than those in the CSM-TACE group (P<0.05). The adverse reactions of the two groups were fever, abdominal pain, stomach discomfort, nausea, and vomiting, and no serious complications occurred. The degree of abdominal pain and fever in the experimental group was lower than that in the control group (P > 0.05).ConclusionsSimultaneous CSM-TACE and PSE using domestic embolization particles for HCC with hypersplenism have good safety and efficacy and has a low incidence of PSE-related adverse events, it is conducive to improving liver function reserve, and can further improve the median OS.
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Wang W, Li F, Gan P, Li B, Li S. Callispheres drug-eluting bead transhepatic artery chemoembolization with oral delivery of sorafenib for the treatment of unresectable liver cancer. Front Surg 2022; 9:981116. [PMID: 36117819 PMCID: PMC9478363 DOI: 10.3389/fsurg.2022.981116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 08/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Liver cancer is a significant contributor to global burden of cancer. Transcatheter arterial chemoembolization (TACE) is the standard of care for patients with unresectable liver cancer, and CalliSpheres, as novel drug-eluting bead (DEB) microspheres, have been found to be associated with a high tumor response rate. However, the outcomes after DEB-TACE treatment are not always satisfactory with tumor recurrence. Herein, we attempt to compare the clinical efficacy and safety of DEB-TACE with sorafenib and conventional TACE in treating advanced liver cancer. Methods The study retrospectively reviewed clinical records of 96 patients with liver cancer, among which there were 48 cases receiving DEB-TACE with sorafenib and 48 cases receiving conventional TACE. The physical properties of Callispheres were evaluated in HepG2 cells and a B6/J mouse model. Results DEB-TACE with Callispheres were demonstrated to effectively maintain stability and prolong the half-life of epirubicin. Compared with the patients receiving conventional TACE, those receiving DEB-TACE with sorafenib exhibited better patient outcomes with increased survival rate, reduced tumor volume, and declined levels of tumor markers. Additionally, DEB-TACE with Callispheres could effectively protect liver function, as well as reduce the toxic effects of loaded epirubicin, and its combination with sorafenib would not increase the incidence of adverse reactions. Conclusion DEB-TACE using CalliSpheres combined with sorafenib could prevent the progression of liver cancer and bring a better prognosis.
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Affiliation(s)
- Wenhui Wang
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, China
- Correspondence: Wenhui Wang
| | - Fenqiang Li
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, China
| | - Peiying Gan
- Department of Neurosurgery, The First Hospital of Lanzhou University, Lanzhou, China
| | - Baohua Li
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, China
| | - Shuangxi Li
- Department of Interventional Medicine, The First Hospital of Lanzhou University, Lanzhou, China
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Zhao G, Liu S, Liu Y, Li X, Yu G, Zhang Y, Bian J, Wu J, Zhou J, Gao F. CalliSpheres® microsphere transarterial chemoembolization combined with 125I brachytherapy for patients with non–small‐cell lung cancer liver metastases. Front Oncol 2022; 12:882061. [PMID: 36033546 PMCID: PMC9413194 DOI: 10.3389/fonc.2022.882061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/07/2022] [Indexed: 12/04/2022] Open
Abstract
Objective Poor prognosis and limited treatments of liver metastases from non–small‐cell lung cancer (NSCLC) after radical surgery are critical issues. The current study aimed to evaluate the efficacy and safety of CalliSpheres® microsphere transarterial chemoembolization (CSM-TACE) plus 125I brachytherapy in these patients. Methods A total of 23 patients with liver metastases from NSCLC after radical surgery were included. All patients received CSM-TACE 1–3 times, then 125I brachytherapy was carried out following the last CSM-TACE. Complete response (CR), objective response rate (ORR), disease control rate (DCR), survival, and adverse events were evaluated. Results CR, ORR and DCR were 43.5%, 87.0%, and 100%, respectively, at three months; furthermore, they were 78.3%, 100%, and 100% accordingly at six months. Moreover, most European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30) subscales of functions (including physical and emotional function) and symptoms (including pain, nausea, and vomiting) were generally improved at three months (all P < 0.05). Furthermore, median progression-free survival (PFS) was 14.0 [95% confidence interval (CI): 10.4–17.6] months, with a 1-year PFS rate of 62.9%, but the 2-year PFS rate was not reached. Moreover, the median overall survival (OS) was 22.0 (95% CI: 16.8–27.2) months, with a 1-year OS rate of 91.3% and a 2-year OS rate of 43.5%. Additionally, the main adverse events included fever (100%), pain (65.2%), liver function impairment (65.2%), fatigue (56.5%), and nausea and vomiting (52.2%), which were all categorized as grade 1–2. Conclusion CSM-TACE plus 125I brachytherapy is effective and safe in patients with liver metastases from NSCLC after radical surgery, providing a potentially optimal option in these patients.
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Affiliation(s)
- Guangsheng Zhao
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Song Liu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, China
| | - Ying Liu
- Hepatobiliary and Pancreatic Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Xiang Li
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Guangji Yu
- Cancer Interventional Center, Linyi Cancer Hospital, Linyi, China
| | - Yuewei Zhang
- Hepatobiliary and Pancreatic Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jie Bian
- Department of Radiology, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jianlin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
| | - Jun Zhou
- Cancer Interventional Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
| | - Fei Gao
- Cancer Interventional Center, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
- *Correspondence: Jun Zhou, ; Jianlin Wu, ; Fei Gao,
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Liu Y, Liu S, Zhao GS, Li X, Gao F, Ren ZZ, Bian J, Wu JL, Zhang YW. Early changes in peripheral blood cytokine levels after the treatment of metastatic hepatic carcinoma with CalliSpheres microspheres drug-eluting beads transcatheter arterial chemoembolization. Front Oncol 2022; 12:889312. [PMID: 35965593 PMCID: PMC9372401 DOI: 10.3389/fonc.2022.889312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 07/07/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveTo observe the early changes in peripheral blood cytokine levels after treatment of metastatic hepatic carcinoma (MHC) with CalliSpheres microspheres drug-eluting beads (DEB) transcatheter arterial chemoembolization (CSM-TACE).MethodsTwenty-eight patients with refractory MHC who underwent CSM-TACE were selected prospectively, and 5mL of peripheral blood was collected before CSM-TACE and on the 2nd and 5th day after CSM-TACE. Flow cytometry was used to detect immunological indicators. The early changes in levels of peripheral blood cell inflammatory factors Th1 (interleukin 2 (IL-2), tumor necrosis factor-α (TNF-a), interferon (IFN-r)), Th2 (IL-4, IL-6, IL-10), and Th17 (IL-17A) were observed after CSM-TACE, as well as the ratio of CD4+/CD8+.ResultsAll the 28 patients underwent CSM-TACE successfully. CT at 4 days after CSM-TACE showed clear outline low-density changes in liver tumors, and honeycomb necrosis was observed in the tumors in some cases. After CSM-TACE, the IL-6 and IL-10 levels were increased and then decreased again. After CSM-TACE, IL-2 showed a trend of transient increase and then decreased again, and the TNF-a level decreased temporarily, and then decreased. After CSM-TACE, the IFN-r level showed a continuous and slowly increasing trend. The IL-17 level showed a continuous downward trend, and the CD4+/CD8+ ratio showed a gradual and continuous upward trend, and there was a negative correlation between them.ConclusionsThere are complex dynamic changes in TH1/Th2 in the early stage of CSM-TACE, and the acute inflammatory response and the enhancement of the body’s immune anti-tumor response coexist.
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Affiliation(s)
- Ying Liu
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Song Liu
- Interventional Medicine Center, Linyi Cancer Hospital, Linyi, China
| | - Guang Sheng Zhao
- Minimally Invasive Interventional Treatment Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
- *Correspondence: Yue Wei Zhang, ; Guang Sheng Zhao,
| | - Xiang Li
- Cancer Treatment Center, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Fei Gao
- Department of Interventional Oncology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Zhi Zhong Ren
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Beijing, China
| | - Jie Bian
- Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, China
| | - Jian Lin Wu
- Department of Radiology, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Yue Wei Zhang
- Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, Beijing, China
- *Correspondence: Yue Wei Zhang, ; Guang Sheng Zhao,
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Hou Z, Liu J, Jin Z, Qiu G, Xie Q, Mi S, Huang J. Use of chemotherapy to treat hepatocellular carcinoma. Biosci Trends 2022; 16:31-45. [PMID: 35173139 DOI: 10.5582/bst.2022.01044] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Hepatic malignancies remain a global challenge. Hepatocellular carcinoma (HCC) accounts for around 90% of patients with liver cancer and is the sixth most common neoplasm worldwide and the fourth leading cause of cancer-related death. However, the long-term prognosis for HCC remains far from satisfactory, with a late diagnosis and limited treatment. DOX has served as conventional chemotherapy with the longest history of use. Although conventional chemotherapy is being challenged by molecular therapy and immune therapy, there is renewed optimism and interest in both systematic and locoregional therapy. Combined chemotherapy is widely used in clinical practice. In specific terms, FOLFOX can serve as a first-line (category 2B) option as recommended by the 2021 NCCN guidelines, while the efficacy of LTLD plus RFA has been confirmed in the phase III HEAT study. These approaches have challenged the dominant status of molecular therapy in terms of health economics and they have potential benefits in Asia, where HBV-related hepatocellular carcinoma is prevalent. Moreover, locoregional chemotherapy can be achieved with TACE and HAIC (possibly involving FOLFOX, DOX, mitomycin C, cisplatin, epirubicin, etc.). TACE was officially recommended by the 2021 NCCN guidelines for patients with Child-Pugh class B liver disease. In addition, HAIC has demonstrated a potential advantage in preliminary clinical practice, although it hasn't been included in any guidelines. Hence, this review summarizes large-scale trials and studies examining the development and innovative use of chemotherapeutic agents. Mounting clinical evidence warrants an exploration of the efficacy of chemotherapy.
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Affiliation(s)
- Ziqi Hou
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jie Liu
- Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhaoxing Jin
- Orthopedics, Tianjin Medical University General Hospital, Tianjin, China
| | - Guoteng Qiu
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Qingyun Xie
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Shizheng Mi
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
| | - Jiwei Huang
- Department of Liver Surgery and Liver Transplantation Center, West China Hospital, Sichuan University, Chengdu, China
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