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Single-Center Trial Indicates No Benefit of Hepatic Artery Chemoembolization vs Embolization in Hepatocellular Carcinoma

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Key Points

  • No difference in response rate was seen for chemoembolization with doxorubicin-eluting beads vs embolization with microspheres alone in patients with hepatocellular carcinoma, according to the findings of a phase II study.
  • No differences were observed in progression-free or overall survival.

In a phase II study reported in the Journal of Clinical Oncology, Brown et al found no apparent benefit of hepatic artery chemoembolization using doxorubicin-eluting microspheres vs embolization with microspheres alone in patients with hepatocellular carcinoma.

Study Details

In the trial, 101 patients from Memorial Sloan Kettering Cancer Center were randomized between December 2007 and April 2012 to receive chemoembolization with microspheres containing doxorubicin at 150 mg (n = 50) or embolization with microspheres alone (n = 51). The primary endpoint was response using multiphase computed tomography 2 to 3 weeks post treatment and at quarterly intervals thereafter. Overall, patients had a median age of 67 years, 77% were male, and 22% had Barcelona Clinic Liver Cancer stage A disease.

Outcomes

Response was observed in 6.0% of the chemoembolization group vs 5.9% of the embolization group (P = .10). Median progression-free survival was 2.8 vs 6.2 months (hazard ratio [HR] = 1.36, P = .11), and median overall survival was 20.8 vs 19.6 months (HR = 1.11, P = .64).

Adverse events occurred in 40% of the chemoembolization group vs 38% of the embolization group (P = .48). There was no significant difference in the number of serious adverse events (71 vs 61, P = .93).

The investigators concluded: “There was no apparent difference between the treatment arms. These results challenge the use of doxorubicin-eluting beads for chemoembolization of hepatocellular carcinoma.”

The study was supported by the National Institutes of Health and the National Cancer Institute.

Karen T. Brown, MD, of Memorial Sloan Kettering Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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