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Combination Trans Arterial Chemoembolization (TACE) Plus Sorafenib for the Management of Unresectable Hepatocellular Carcinoma: A Systematic Review of the Literature

Digestive diseases and sciences, 2013-12, Vol.58 (12), p.3389-3396 [Peer Reviewed Journal]

Springer Science+Business Media New York 2013 ;COPYRIGHT 2013 Springer ;Springer Science+Business Media New York 2013. ;ISSN: 0163-2116 ;EISSN: 1573-2568 ;DOI: 10.1007/s10620-013-2872-x ;PMID: 24046163

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Title:
Combination Trans Arterial Chemoembolization (TACE) Plus Sorafenib for the Management of Unresectable Hepatocellular Carcinoma: A Systematic Review of the Literature
Author: Abdel-Rahman, O. ; Elsayed, Z. A.
Subjects: Analysis ; Antineoplastic Agents - administration & dosage ; Antineoplastic Agents - adverse effects ; Aspartate ; Biochemistry ; Carcinoma, Hepatocellular - drug therapy ; Carcinoma, Hepatocellular - mortality ; Chemoembolization ; Chemoembolization, Therapeutic ; Clinical Trials as Topic ; Gastroenterology ; Hepatology ; Hepatoma ; Humans ; Liver ; Liver cancer ; Liver diseases ; Liver Neoplasms - drug therapy ; Liver Neoplasms - mortality ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Niacinamide - administration & dosage ; Niacinamide - adverse effects ; Niacinamide - analogs & derivatives ; Oncology ; Phenylurea Compounds - administration & dosage ; Phenylurea Compounds - adverse effects ; Retrospective Studies ; Review ; Systematic review ; Transplant Surgery
Is Part Of: Digestive diseases and sciences, 2013-12, Vol.58 (12), p.3389-3396
Description: Background Hepatocellular carcinoma (HCC) is the most common liver neoplasm and the fifth most common cancer worldwide. Intermediate stage HCC [traditionally defined as Barcelona Clinic Liver Cancer (BCLC) B disease and traditionally treated with trans arterial chemoembolization (TACE)] and advanced stage HCC (traditionally defined as BCLC C disease and traditionally treated with sorafenib) are two distinct disease entities with rapidly evolving multimodality treatment approaches. In this systematic review we explore the evidence surrounding the value of using a TACE/sorafenib combination in these two subsets of HCC. Methods PubMed, Medline, the Cochrane Library, EMBASE and Google Scholar were searched using the terms “HCC” OR “Hepatoma” or “Liver cancer” AND “TACE” OR “Chemoembolization” AND “Sorafenib” and specifying only English literature. Outcomes of interest included time to progression and overall survival (TTP and OS), tumor response, and toxicities. Results A total of 17 potentially relevant trials were identified, of which six studies were excluded. Hence, 11 trials involving 1,000 patients were included, encompassing two phase 1 studies, one phase 3 study, two retrospective analyses and six phase 2 studies. Median TTP was reported in five out of 11 studies and it ranged from 6.3 to 9.0 months. Median OS was reported in five out of 11 studies and it was similarly variable as PFS, ranging from 12 to 29 months. The DCR (disease control rate) was reported in eight out of 11 studies, ranging from 32 to 95 %. Frequently reported grade 3/4 toxicities were increased aspartate transaminase/alanine transaminase, fatigue, hypertension, hand-foot skin reaction and diarrhea. Conclusions The sorafenib/TACE combination shows promise as an effective and tolerable treatment strategy for intermediate stage/advanced HCC. The reported efficacy of a sorafenib/TACE combination appears to compare favorably with sorafenib or TACE monotherapies, the most commonly implemented strategies for unresectable HCC. Further clinical studies are warranted to accurately determine which patients are expected to benefit most from such combination strategies.
Publisher: Boston: Springer US
Language: English
Identifier: ISSN: 0163-2116
EISSN: 1573-2568
DOI: 10.1007/s10620-013-2872-x
PMID: 24046163
Source: AUTh Library subscriptions: ProQuest Central
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Combination Trans Arterial Chemoembolization (TACE) Plus Sorafenib for the Management of Unresectable Hepatocellular Carcinoma: A Systematic Review of the Literature

Springer Science+Business Media New York 2013 ;COPYRIGHT 2013 Springer ;Springer Science+Business Media New York 2013. ;ISSN: 0163-2116 ;EISSN: 1573-2568 ;DOI: 10.1007/s10620-013-2872-x ;PMID: 24046163

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