| Title | Exploratory Analysis to Identify Candidates Benefitting from Combination Therapy of Transarterial Chemoembolization and Sorafenib for First-Line Treatment of Unresectable Hepatocellular Carcinoma: A Multicenter Retrospective Observational Study |
| Authors | Wang, Zhexuan Wang, Enxin Bai, Wei Xia, Dongdong Ding, Rong Li, Jiaping Wang, Qiuhe Liu, Lei Sun, Junhui Mu, Wei Zhao, Hui Pan, Xingnan Shao, Guoliang Zhu, Xiaoli Yin, Guowen Shi, Haibin Wu, Jianbing Lin, Zhengyu Yang, Shufa Liu, Jueshi Wang, Wenhui Zhu, Xu Lv, Yong Li, Jing Chen, Hui Wang, Wenjun Li, Kai Yuan, Xulong Yu, Tanlei Yuan, Jie Li, Xiaomei Niu, Jing Yin, Zhanxin Xia, Jielai Fan, Daiming Han, Guohong |
| Affiliation | Fourth Mil Med Univ, Natl Clin Res Ctr Digest Dis, Dept Liver Dis & Digest Intervent Radiol, 15 West Changle Rd, Xian 710032, Peoples R China Fourth Mil Med Univ, Xijing Hosp Digest Dis, 15 West Changle Rd, Xian 710032, Peoples R China Kunming Univ, Tumor Hosp Yunnan Prov, Dept Minimally Invas Int Therapy, Affiliated Hosp 3, Kunming, Yunnan, Peoples R China Sun Yat Sen Univ, Dept Intervent Radiol, Affiliated Hosp 1, Guangzhou, Peoples R China Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Hepatobiliary & Pancreat Intervent Canc, Hangzhou, Peoples R China Third Mil Med Univ, Southwest Hosp, Dept Radiol, Chongqing, Peoples R China Nantong Univ, Dept Intervent Radiol, Affiliated Hosp, Nantong, Peoples R China 180th Hosp PLA, Clin Liver Dis Res Ctr, Nanjing Mil Command, Quanzhou, Peoples R China Zhejiang Canc Hosp, Dept Radiol, Hangzhou, Peoples R China Soochow Univ, Dept Intervent Radiol, Affiliated Hosp 1, Suzhou, Peoples R China Nanjing Med Univ, Jiangsu Prov Canc Hosp, Dept Intervent Radiol, Affiliated Canc Hosp, Nanjing, Peoples R China Nanjing Med Univ, Dept Intervent Radiol, Affiliated Hosp 1, Nanjing, Peoples R China Nanchang Univ, Dept Oncol, Affiliated Hosp 2, Nanchang, Jiangxi, Peoples R China Fujian Med Univ, Dept Intervent Radiol, Affiliated Hosp 1, Fuzhou, Peoples R China Xinjiang Med Univ, Dept Intervent Radiol, Affiliated Tumor Hosp, Urumqi, Peoples R China Hunan Prov Peoples Hosp, Dept Intervent Radiol & Vasc Surg, Changsha, Peoples R China Lanzhou Univ, Dept Intervent Med, Affiliated Hosp 1, Lanzhou, Peoples R China Peking Univ, Dept Intervent Radiol, Canc Hosp, Beijing, Peoples R China Fourth Mil Med Univ, Dept Med Stat, Xian, Peoples R China Fourth Mil Med Univ, State Key Lab Canc Biol, Xian, Peoples R China |
| Keywords | CLINICAL-PRACTICE PHASE-III TACE STAGE SUBCLASSIFICATION PREDICTORS SUBGROUPS SURVIVAL TRIALS |
| Issue Date | Jun-2020 |
| Publisher | LIVER CANCER |
| Abstract | Introduction:The benefits of combining transarterial chemoembolization (TACE) and sorafenib (TACE-S) over TACE alone for treatment of unresectable hepatocellular carcinoma (HCC) remain controversial. Yet, such populations are heterogeneous in terms of baseline characteristics.Objective:To investigate the predictors of survival benefits from added sorafenib and identify the potential candidates for TACE-S.Methods:This multicenter observational study was conducted in 17 Chinese tertiary hospitals for patients with unresectable, liver-confined HCC. Eligible patients with performance status score of <= 1 and Child-Pugh score of <= 7 were treated with TACE or TACE-S. Interactions between treatment and baseline variables were evaluated to find indicators for survival benefits, based on which the patients were stratified. Multivariate models adjusted for baseline characteristics or propensity score were used to compare overall survival (OS) and time to tumor progression (TTP).Results:From January 2009 to December 2015, 1,719 consecutive patients received TACE (n= 1,406) or TACE-S (n= 313). Although TACE-S compared with TACE improved TTP (adjusted hazard ratio [HR] 0.75,p= 0.008), no difference in OS was observed (adjusted HR 0.87,p= 0.090). Nevertheless, the tumor burden (sum of maximum diameter of largest tumor [cm] and tumor number) and albumin-bilirubin (ALBI) score independently predicted the survival benefits from added sorafenib (interactionp< 0.001). For patients with either moderate tumor burden (7-13) or low ALBI score (no more than -2.8) defined as candidates, TACE-S prolonged OS (adjusted HR 0.73,p= 0.003) and TTP (adjusted HR 0.72,p= 0.014) compared to TACE alone, whereas its superiority disappeared in non-candidates.Conclusions:Not all unresectable HCC patients but those with moderate tumor burden or low ALBI score achieve survival benefits from TACE-S compared with TACE alone. Future randomized controlled trials focusing on the subset are warranted. |
| URI | http://hdl.handle.net/20.500.11897/590708 |
| ISSN | 2235-1795 |
| DOI | 10.1159/000505692 |
| Indexed | SCI(E) |
| Appears in Collections: | 北京肿瘤医院 |
