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Malagari K, Kiakidis T, Moschouris H, Charokopakis A, Vergadis C, Alevisopoulos N, Kartsouni V, Panagiotou I, Pellerin O, Glantzounis G, Filippiadis DK, Emmanouil E, Tsavaris N, Psarros G, Delicha E, Kelekis N. Prospective Series of Transarterial Chemoembolization of Metastatic Colorectal Cancer to the Liver with 30-60 μm Microspheres Loaded with Irinotecan. Cardiovasc Intervent Radiol 2023:10.1007/s00270-023-03446-6. [PMID: 37337059 DOI: 10.1007/s00270-023-03446-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/13/2023] [Indexed: 06/21/2023]
Abstract
PURPOSE To describe safety and clinical outcomes among patients with metastatic colorectal cancer (mCRC) to the liver treated with transarterial chemoembolization with HepaSphere™ Microspheres 30-60 μm loaded with irinotecan (ΙRI-HEP-TACE). MATERIAL AND METHODS In this prospective study (NCT04866290), 100 adults with confirmed mCRC to the liver who were ineligible for resection were enrolled and followed up to 24 months or death. Study outcomes among Salvage (patients not tolerating more cycles of chemotherapy) and Non-salvage patients included overall survival (OS), progression-free survival (PFS), objective response (OR), objective response rate (ORR), best tumor response (BTR), adverse events (AEs), and pharmacokinetics of irinotecan and its active metabolite, 7-ethyl-10-hydroxy-camptothecin (SN38). RESULTS The median age was 66 years (range: 31-89). Median OS was 15.08 months (95% confidence interval [CI]: 12.33-17.25). PFS was 8.52 months (95% CI: 6.0-9.0; p < 0.001). ORR was 42.2% (95% CI: 31.57-53.50) and 35.9% (95% CI: 25.57-47.62) based on modified RECIST (Response Evaluation Criteria in Solid Tumors) and RECIST 1.1 criteria. BTR was not significantly different between mRECIST and RECIST (p = 0.745). The Non-salvage group had a statistically significant difference in median OS relative to the Salvage group (15.3 vs. 3 months; p < 0.001). Pharmacokinetic analyses demonstrated no correlation of OS with plasma concentration of irinotecan and SN38 (all p > 0.05). Most AEs were Grade 2 (257/279), the most common AE was right upper abdominal pain (180/279). One major AE (tumor rupture) was reported. CONCLUSION IRI-HEP-TACE is an alternative treatment for patients with Non-salvage mCRC to the liver.
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Affiliation(s)
- K Malagari
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15 669 Papagou, Athens, Greece.
- Evgenidion and Attikon University Hospitals, Chaidari, Greece.
| | - Th Kiakidis
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15 669 Papagou, Athens, Greece
- Evgenidion and Attikon University Hospitals, Chaidari, Greece
| | - H Moschouris
- Interventional Radiology Department, Tzanion General Hospital, Piraeus, Athens, Greece
| | - A Charokopakis
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15 669 Papagou, Athens, Greece
- Evgenidion and Attikon University Hospitals, Chaidari, Greece
| | | | | | - V Kartsouni
- Department of Interventional Radiology, Agios Savvas Anticancer Hospital, Athens, Greece
| | - Ir Panagiotou
- Department of Internal Medicine, Agios Savvas Anticancer Hospital, Αthens, Greece
| | - O Pellerin
- Interventional Radiology, Université de Paris-Citè, PARCC, INSERM, 75006, Service de Radiologie Interventionnelle Assistance Publique - Hôpitaux de Paris Hôpital Européen Georges Pompidou, Paris, France
| | | | - D K Filippiadis
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15 669 Papagou, Athens, Greece
- Evgenidion and Attikon University Hospitals, Chaidari, Greece
| | - E Emmanouil
- Department of Radiology, Amalia Fleming Hospital, Athens, Greece
| | | | - G Psarros
- ASTAT-Statistics in Clinical Research, 166 75, Athens, Greece
| | - E Delicha
- ASTAT-Statistics in Clinical Research, 166 75, Athens, Greece
| | - N Kelekis
- Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15 669 Papagou, Athens, Greece
- Evgenidion and Attikon University Hospitals, Chaidari, Greece
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Malagari K, Moschouris H, Kiakidis T, Harward S, Kelekis A, Vrakas S, Koundouras D, Filipiadis D, Glantzounis G, Emmanouil E, Chatziioannou A, Vergadis V, Elefsiniotis I, Koskinas J, Dourakis S, Kelekis N. Five-Years Outcome Analysis of 142 Consecutive Hepatocellular Carcinoma Patients Treated with Doxorubicin Eluting Microspheres 30-60 μm: Results from a Single-Centre Prospective Phase II Trial. Cardiovasc Intervent Radiol 2019; 42:1551-1562. [PMID: 31321482 DOI: 10.1007/s00270-019-02260-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 06/03/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess prospectively long-term results of doxorubicin-loaded HepaSphere 30-60 μm in consecutive patients with hepatocellular carcinoma (HCC) not amenable to curative treatments. PATIENTS AND METHODS Single-center study from June 2011 to December 2015 in 151 patients treated with 75 mg of doxorubicin per HepaSphere vial. Baseline: Barcelona Clinic Liver Cancer BCLC A/B was 49.3%/50.7%, and median diameter 6.1 cm (mean 6.7 ± 2.0). Liver function, local response (mRECIST), liver time to progression (LTTP), progression-free survival (PFS), overall survival (OS) and adverse events (AEs) were recorded. RESULTS Final analysis included 142 patients with median follow-up of 46.8 months (range 4-72) without grade 4/5 AEs, and 30-day mortality was 0%. Mean number of scheduled treatments was 2.6 (range 1-3) and on demand 3 (range 1-8). Complete response for single tumor ≤ 5 cm was 75.0% and 66.7% for Child A and Child B, while for > 5 cm was 28.6% and 11.8%, respectively. OS was 31.0 months (mean 33.3 ± 15.2; range 8-69), notably for BCLC A 41 months (mean 41.1 ± 15.3; range 13-69) and for BCLC B 26.0 (mean 26.0 ± 10.5; range 8-51). OS at 1, 3 and 5 years: 95.8%, 75.7% and 21.4% for BCLC A, and 94.4%, 36.1% and 2.7% for BCLC B. Median LTTP for BCLC A was 11 months (mean 11.9 ± 4.7; range 3-24) and 7.5 for BCLC B (mean 7.9 ± 2.9). Local response was significant for OS and LTTP (p < 0.0001), while size and lesion number affected LPFS and OS (p < 0.001). CONCLUSIONS HepaSphere 30-60 μm loaded with doxorubicin provides a safe and effective treatment option for patients with HCC.
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Affiliation(s)
- K Malagari
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece. .,Attikon Hospital, Chaidari, Greece. .,Evgenidion Hospital, Athens, Greece.
| | - H Moschouris
- Radiology Department of Tzanion General Hospital, Athens, Greece
| | - Th Kiakidis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Harward
- University of Massachusets Medical School, Worcester, MA, USA
| | - A Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
| | - S Vrakas
- Tzanion Hospital, Athens, Greece
| | - D Koundouras
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - D Filipiadis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece
| | - G Glantzounis
- Department of Surgery, University Hospital of Ioannina (UOI), Ioannina, Greece
| | - E Emmanouil
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Evgenidion Hospital, Athens, Greece
| | - A Chatziioannou
- Evgenidion Hospital, Athens, Greece.,1st Department of Radiology, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - V Vergadis
- Radiology Department of Laikon University Hospital, Athens, Greece
| | - I Elefsiniotis
- Department of Internal Medicine and Hepatology Unit, Agioi Anargyroi General and Oncology Hospital of Kifissia Hospital Timiou Stavrou and Noufaron, Kalyftaki, Athens, Greece
| | - J Koskinas
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - S Dourakis
- 2nd Clinic of Medicine and Hepatology Medical School, National and Kapodistrian University of Athens, Athens, Greece.,2nd Clinic of Internal Medicine University of Athens Hippokration Hospital, Athens, Greece
| | - N Kelekis
- 2nd Department of Radiology, Medical School, National and Kapodistrian University of Athens, 19 Monis Kyccou, 15669, Papagou, Athens, Greece.,Attikon Hospital, Chaidari, Greece.,Evgenidion Hospital, Athens, Greece
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