Gontran Verset et al. Hepatic Oncology(2020)
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5/21/2021 -
- 24 patients with 40 HCC lesions underwent B-DEM-TACE
- Adverse events were evaluated at 24 h and 1 month
- Imaging response according to modified response evaluation criteria in solid tumours was assessed at 1, 3 and 6 months
Figure 1. Treatment allocations according to OAC indication
*ASA, acetylsalicylic acid; M, months; P2Y12i, P2Y12 inhibitor; PCI, percutaneous coronary intervention; SAPT, single antiplatelet therapy.
Three co-primary outcomes were assessed:
- Net adverse clinical events (NACE) – a composite of death from any cause, myocardial infarction (MI), stroke, and type 3 or 5 bleeding according to the Bleeding Academic Research Consortium (BARC).
- Major adverse cardiac and cerebral events (MACCE) – a composite of death from any cause, MI, and stroke.
- Major or clinically relevant nonmajor bleeding (MCB) – a composite of BARC bleeding type 2, 3, or 5.
- Nine patients (37.5%) received a second treatment and two of them (22.2%) went on to a third treatment without worsening of the liver function.
- All 24 patients were candidates for multimodal treatment after B-DEM-TACE due to the lack of hepatic injury. `
- The 1-month follow-up imaging post-treatment by contrast-enhanced MRI was available for 39 nodules and showed an overall response per nodule of 74.3% (48.7% CR and 25.6% PR) and a best overall response of 70.9% (41.7% CR and 29.2% PR)
Gontran Verset et al concluded that B-DEM-TACE has proven to be an effective treatment for HCC patients with a very good safety profile. In our series we have observed fewer AEs than previously described with other catheters, suggesting an added value of this technique in terms of liver function preservation. If future trials will confirm these observations, B-DEM-TACE may become a valuable tool for intra-arterial LRTs mostly for frail patients.
Key Takeaway:
The main findings of Gontran Verset et al are that:
- This technique enables to improve the selectivity of TACE, which is an added value for the treatment of HCC particularly in cirrhotic patients, who are most likely to present an impaired liver function.
- Currently, a key point of locoregional therapy is the preservation of liver function, ever since the development of various systemic therapies that improve OS of these patients.
Access to full publication: https://www.futuremedicine.com/doi/10.2217/hep-2020-0022
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