Qi JS, Zhao P, Zhao XB, Zhao YL, Guo YC. Small particle drug-eluting beads-transarterial chemoembolization combined with targeted therapy in the clinical treatment of unresectable liver cancer. World J Gastrointest Oncol 2024; 16(10): 4157-4165 [DOI: 10.4251/wjgo.v16.i10.4157]
Corresponding Author of This Article
Jing-Song Qi, MMed, Associate Chief Physician, Department of Interventional, The First Affiliated Hospital of Xinxiang Medical University, No. 88 Jiankang Road, Weihui, Xinxiang 453100, Henan Province, China. jingsong05010403@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Observational Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Oncol. Oct 15, 2024; 16(10): 4157-4165 Published online Oct 15, 2024. doi: 10.4251/wjgo.v16.i10.4157
Small particle drug-eluting beads-transarterial chemoembolization combined with targeted therapy in the clinical treatment of unresectable liver cancer
Jing-Song Qi, Peng Zhao, Xiao-Bo Zhao, Yong-Li Zhao, Ying-Chang Guo, Department of Interventional, The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, Henan Province, China
Author contributions: Qi JS conceptualized the study and supervised the project; Qi JS and Zhao P collected data, preformed the research, wrote the manuscript and prepared the original draft; Zhao XB, Zhao YL and Guo YC did the validation, investigation, and analysis of the data; All authors have reviewed, edited, read and approved the final manuscript.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of The First Affiliated Hospital of Xinxiang Medical University, No. 2019-XXLY-001.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data. So, the Institutional Review Board has waived the informed consent from patients.
Conflict-of-interest statement: The authors report no relevant conflicts of interest for this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jing-Song Qi, MMed, Associate Chief Physician, Department of Interventional, The First Affiliated Hospital of Xinxiang Medical University, No. 88 Jiankang Road, Weihui, Xinxiang 453100, Henan Province, China. jingsong05010403@163.com
Received: June 5, 2024 Revised: August 7, 2024 Accepted: August 12, 2024 Published online: October 15, 2024 Processing time: 112 Days and 22.8 Hours
Abstract
BACKGROUND
Liver cancer is a highly malignant tumor with significant clinical impact. Chemotherapy alone often yields suboptimal outcomes in both the short and long term, characterized by high rates of local recurrence and distant metastasis, leading to a poor long-term prognosis.
AIM
To evaluate the clinical efficacy of small particle drug-eluting beads-transarterial chemoembolization (DEB-TACE) combined with targeted therapy for the treatment of unresectable liver cancer.
METHODS
We analyzed clinical data from 74 patients with unresectable liver cancer admitted between January 2019 and December 2020. Based on the different treatment regimens administered, patients were divided into the control (36 patients receiving sorafenib alone) and joint (38 patients receiving small particle DEB-TACE combined with sorafenib) groups. We compared liver function indicators [alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL), albumin (ALB)] and serum tumor markers [alpha fetoprotein (AFP)] before and after treatment in both groups. Short-term efficacy measures [complete response (CR), partial response, progression disease, stable disease, objective response rate (ORR), and disease control rate (DCR)] were assessed post-treatment. Long-term follow-up evaluated median overall survival (OS), progression-free survival (PFS), and adverse reaction rates between the two groups.
RESULTS
One month post-treatment, the joint group demonstrated significantly higher rates of CR, ORR, and DCR compared to the control group (P < 0.05). Three days after treatment, the joint group showed elevated levels of ALT, AST, and TBIL but reduced levels of ALB and AFP compared to the control group (P < 0.05). The median OS was 18 months for the control group and 25 months for the joint group, while the median PFS was 15 months for the control group and 22 months for the joint group, with significant differences observed (log-rank: χ2 = 7.824, 6.861, respectively; P = 0.005, 0.009, respectively). The incidence of adverse reactions was not significantly different between the groups (P > 0.05).
CONCLUSION
The combination of small particle DEB-TACE and sorafenib significantly improves both short- and long-term outcomes in the treatment of unresectable liver cancer while preserving liver function.
Core Tip: This study compared the efficacy of single-agent sorafenib targeted therapy and its combination with small particle drug-eluting beads-transarterial chemoembolization (DEB-TACE) in patients with unresectable liver cancer. The results demonstrate that combining small particle DEB-TACE with sorafenib significantly enhances both short- and long-term treatment outcomes compared to single-agent therapy. This combination approach improves liver function, reduces tumor marker levels, boosts overall treatment efficacy, and enhances patient prognosis. This approach is safe, reliable, and holds significant clinical utility.
