Hepatic arterial infusion chemotherapy with fine-powder cisplatin and iodized-oil suspension in patients with intermediate-stage and advanced-stage (Barcelona Clinic Liver Cancer stage-B or stage-C) hepatocellular carcinoma: multicenter phase-II clinical study

• Published in: International journal of clinical oncology 2015-08, Vol.20 (4), p.745-754
• Main Authors: Takaki, Haruyuki, Yamakado, Koichiro, Tsurusaki, Masakatsu, Yasumoto, Taku, Baba, Yasutaka, Narimatsu, Yoshiaki, Shimohira, Masashi, Yamaguchi, Masato, Matsuo, Kunihiro, Inaba, Yoshitaka, Mikami, Koji, Watanabe, Ryohei, Nishida, Norifumi, Anai, Hiroshi, Kakizawa, Hideaki, Hirota, Shozo
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cancer Research; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Chemotherapy; Cisplatin - administration & dosage; Female; Hepatic Artery; Humans; Infusions, Intra-Arterial; Iodized Oil - administration & dosage; Liver cancer; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Staging; Oncology; Original Article; Powders; Prospective Studies; Surgical Oncology; Treatment Outcome
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-014-0773-4

Purpose This single-arm, multicenter, phase-II trial evaluated the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) using fine-powder cisplatin and iodized-oil suspension in patients with intermediate- and advanced-stage [Barcelona Clinic Liver Cancer (BCLC) stage-B and stage-C] hepatocellular carcinomas (HCCs). Methods The Institutional Review Board approved this study and patients provided written informed consent. Thirty-five patients (24 men and 11 women, mean 74 ± 6 years [range 60–87 years]) with BCLC stage-B (57 %, 20/35) or stage-C (43 %, 15/35) HCCs who were not candidates for other locoregional treatments were enrolled. HAIC was performed using a suspension of fine-powder cisplatin with a maximum dose of 65 mg/m 2 and iodized oil on demand. The primary endpoint was the response rate evaluated based on Response Evaluation Criteria in Solid Tumor (RECIST) and modified RECIST (mRECIST). Secondary endpoints were overall survival, progression-free survival, and safety. Results The initial and best overall response rates at 4 weeks and 3 months, respectively, were 14 and 17 % based on RECIST, and 57 and 23 % based on mRECIST. The median overall and progression-free survival times were 18 and 4 months, respectively. The most frequent grade-3 or grade-4 adverse events were elevation of serum alanine (23 %) and aspartate aminotransferase (20 %), and thrombocytopenia (17 %). Conclusion This HAIC provides promising therapeutic effects with acceptable safety to patients with intermediate-stage and advanced-stage HCCs.