The safety and efficacy of oxaliplatin-loaded drug-eluting beads transarterial chemoembolization for the treatment of unresectable or advanced lung cancer

Aim: Drug-eluting beads are usually applied for the treatment of advanced hepatocellular carcinoma. Oxaliplatin was suggested as first-line therapy for advanced non-small-cell lung cancer. However, there has been little investigation about the application of drug-eluting beads transarterial chemoembolization (DEB-TACE) with oxaliplatin-loaded CalliSpheres beads (CB) for the treatment of unresectable or advanced lung cancer. We aimed to investigate the safety and efficacy of oxaliplatin-loaded DEB-TACE for the treatment of unresectable or advanced lung cancer. Methods: From January 2019 to December 2021, all patients with primary unresectable or advanced lung cancer who underwent DEB-TACE with oxaliplatin-loaded CB were retrospectively enrolled. This study defined overall survival and objective response rate (ORR) as the primary endpoints, disease control rate (DCR) and progression-free survival (PFS) as the secondary endpoints. Results: A total of 33 sessions of DEB-TACE were performed in 20 patients, with a mean of 1.7 ± 1.0 sessions. A total of 55 arteries were emoblized by CB, including 40 bronchial arteries, 13 intercostal arteries, one suprarenal artery and one inferior phrenical artery. No procedural-related mortality or severe complications were observed. The median tumor diameter was 49.0 [Interquartile range (IQR) 37.8-66.8] mm before DEB-TACE, and decreased to 38.8 (IQR 27.7-56.9), 26.1 (IQR 19.1-48.8), and 20.5 (IQR 13.1-49.7) mm at 1, 3 and 6 months later (p = 0.04). The ORR and DCR at 1, 3, and 6 months after DEB-TACE were 28.6% and 92.9%, 38.5% and 84.6%, 30.8% and 61.5%, respectively. The median PFS and median overall survival was 9.9 and 29.6 months, respectively. Conclusion: DEB-TACE with oxaliplatin-loaded CB is suggested as a safe, effective and well-tolerated treatment for patients with unresectable or advanced lung cancer.

Comprehensive Analysis of Factors Affecting Clinical Response and Short-Term Survival to Drug-Eluting Bead Transarterial Chemoembolization for Treatment in Patients With Liver Cancer

This study aimed to investigate the clinical response and short-term survival and further explore the comprehensive factors for predicting clinical outcomes in patients with liver cancer treated by drug-eluting beads transarterial chemoembolization . Forty-nine patients with liver cancer who received drug-eluting beads transarterial chemoembolization treatment were consecutively enrolled in this cohort study. Demographic features, medical histories, clinicopathological properties, biochemical indexes, previous treatments, and chemoembolization reagents were recorded. Ten (20.4%) patients achieved complete response and 31 (63.3%) patients achieved partial response after drug-eluting beads transarterial chemoembolization treatment, with overall response rate of 83.7%. Logistic analysis revealed that high aspartate aminotransferase (P = .041), high carbohydrate antigen 199 (P = .030), and low hemoglobin (P = .020) could independently predict less possibility for complete response achievement. As to survival analysis, high alkaline phosphatase (P = .040), low albumin (P = .033) low hemoglobin (P = .018), portal vein invasion (P = .025), higher Eastern Cooperative Oncology Group performance status (P = .011), and higher Child-pugh stage (P = .001) were independent predictors for worse overall survival. In conclusion, the present study validated that drug-eluting beads transarterial chemoembolization was effective and well tolerated for patients with liver cancer, and high aspartate aminotransferase, high alkaline phosphatase, low albumin, low hemoglobin, portal vein invasion, higher Child-pugh stage, higher Barcelona Clinic Liver Cancer stage, higher Eastern Cooperative Oncology Group performance status were correlated with worse outcomes.

Drug-eluting bead transarterial chemoembolization is efficient and well-tolerated in treating elderly Chinese hepatocellular carcinoma patients

This study aimed to evaluate the efficacy and safety of drug-eluting bead transarterial chemoembolization (DEB-TACE), and to explore its prognostic factors in elderly Chinese hepatocellular carcinoma (HCC) patients. 93 elderly HCC patients undergoing DEB-TACE were prospectively enrolled. Treatment response was assessed by mRECIST criteriaat1 month post DEB-TACE treatment, and progression free survival (PFS) and overall survival (OS) were calculated. Liver function and adverse events (AEs) within 1 month post DEB-TACE were documented. Complete response (CR) rate and objective response rate (ORR) were 18.3% and 87.1%, respectively. Additionally, medians of PFS and OS were 9.0 months and 21.0 months, respectively. Multivariate logistic regression revealed that no factor independently predicted CR achievement, while tumor size ≥5.0 cm and AFP abnormal were independent factors for predicting both shorter PFS and OS, and higher BCLC stage was an independent predictive factor for unfavorable OS. As to safety profiles, the percentages of patients with abnormal TBIL, ALT, AST, and ALP were increased at 1 week, while they were not different at 1 month post DEB-TACE treatment compared with baseline. Most frequent AEs were pain, fever, nausea or vomiting; skin discolorations, myelosuppression, and other AEs were relatively rare. In conclusion, DEB-TACE was efficient and well tolerated in elderly HCC patients, and increased tumor size, abnormal AFP, as well as higher BCLC stage could be independent markers for predicting worse prognosis.