Scientific Session 01 — Vascular/Interventional - Oncology and Tissue SamplingMonday, May 1, 2017
1098. Tumor Response/Survival Outcomes; Oncozene Beads Used in TACE for Unresectable HCC
Abdel Aal A, Moawad S*, Saddekni S, Jackson B, Baalmann C. University of Alabama at Birmingham, Birmingham, United States
Address correspondence to A. Abdel-Aal (firstname.lastname@example.org)
Objective: The purpose of the study is to evaluate the tumor response rate and survival outcomes of a transarterial chemoembolization (TACE) of unresectable hepatocellular carcinoma (HCC) using 75-µm Oncozene (Boston Scientific) drug-eluting beads (DEBs).
Materials and Methods: We retrospectively reviewed the medical records and radiologic studies of 67 patients who had their first TACE for HCC between November 2013 and December 2015 using 75-µm Oncozene DEBs. Patients who had lesions previously treated with other TACE agents or other locoregional therapy were excluded. A follow-up CT, MRI, or both were done 4–6 weeks after TACE. The primary endpoint of the study was tumor response rate, which was categorized according to the modified Response Evaluation Criteria in Solid Tumors and the toxicity profile of the DEB using Common Terminology Criteria for Adverse Events version 3.0. The secondary endpoint was patient survival.
Results: The study included 52 (77.6%) men and 15 (22.4%) women with a mean age of 63.8 years. The hepatitis C and hepatitis B viruses were present in 58% and 6% of patients, respectively. Patients with a Child-Pugh A score and Barcelona Clinic Liver Cancer (BCLC) stages A and B constituted 72% and 85% of the patient population, respectively. Overall tumor response was 24% complete response, 78% objective response, and 88% disease control. Complete response, objective response, and disease control were 27%, 75%, and 88%, respectively, in patient with a Child-Pugh A score, and 26%, 79%, and 91%, respectively, in patients with BCLC stages A and B. Complete response, objective response, and disease control were 16%, 84%, and 89%, respectively, in patients with Child-Pugh B and C scores, and 10%, 70%, and 70%, respectively, in patients with BCLC stages C and D. We did not observe a statistically significant difference across Child-Pugh or BCLC staging. Grade 3 toxicity was seen in 9% of the patients. There was no grade 4 toxicity recorded. Overall survival rates for 6, 12, and 24 months were 96% (95% CI, 87.3–99.9%, p < 0.0001), 82% (95% CI, 68.6–92.1%, p < 0.0001), and 31% (95% CI, 11–58.7%, p = 0.1336), respectively.
Conclusion: The present study shows very good tumor response rate to TACE using 75-µm Oncozene DEBs with a very low toxicity profile. Short-term survival outcomes appear to be promising with 98% and 90% survival at 6 and 12 months, respectively.