Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.9104
Revised: October 8, 2013
Accepted: November 2, 2013
Published online: December 21, 2013
Processing time: 137 Days and 18.2 Hours
AIM: To investigate the safety and effectiveness of combined 131I-metuximab and transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC).
METHODS: One hundred and eighty-five patients (159 men and 26 women) with advanced HCC were enrolled in this study from February 2009 to July 2011. There were 95 patients in the combined metuximab and TACE group, and 90 patients in the TACE only group. The patients were followed for 12 mo. Clinical symptoms, blood cell counts, Karnofsky Performance Score (KPS) evaluation and therapeutic effects according to the Response Evaluation Criteria in Solid Tumors were recorded and evaluated.
RESULTS: The 1-mo effective rates (complete response + partial response + stable disease) of the test group and control group were 71.23% and 38.89%, respectively (P < 0.001). The 6-, 9- and 12-mo survival rates were 86.42%, 74.07% and 60.49% for the test group and 60.0%, 42.22% and 34.44% for the control group (P < 0.001). The incidence of adverse events (gastrointestinal symptoms, fever and pain) and blood cell toxicity were significantly higher for the test group than for the control group (P < 0.001). No severe 131I-metuximab-related complications were identified. With respect to efficacy, patients in the test group had greater improvement in tumor-related pain (P = 0.014) and increase in KPS (P < 0.001) than those in the control group.
CONCLUSION: Combination of 131I-metuximab and TACE prolonged the survival time in patients with HCC compared with TACE alone. The combination treatment was safe and effective.
Core tip:131I-metuximab has high affinity with a target antigen highly expressed on hepatocellular carcinoma (HCC) cells and a limited area of action. The combination of metuximab and transcatheter arterial chemoembolization had a synergistic effect in the treatment of HCC. It may represent a promising treatment modality for patients with advanced HCC, especially for those patients with multiple nodules who have a heavy tumor burden.