Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study

• Published in: Clinical therapeutics 2019-08, Vol.41 (8), p.1463-1476
• Main Authors: Fan, Wenzhe, MD, Yuan, Guosheng, PhD, Fan, Huishuang, MSc, Li, Fuliang, MSc, Wu, Yanqin, MD, Zhao, Yue, MD, Yao, Wang, MD, Wang, Yu, MD, Xue, Miao, MD, Yang, Jianyong, MD, Li, Jiaping, MD
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; alpha-Fetoproteins - analysis; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; apatinib; Blood clots; Cancer therapies; Carcinoma, Hepatocellular - blood; Carcinoma, Hepatocellular - therapy; Chemoembolization; Chemoembolization, Therapeutic; Chemotherapy; Enzyme inhibitors; Female; Gastric cancer; Hepatocellular carcinoma; Hospitals; Humans; Internal Medicine; Kinases; Liver cancer; Liver Neoplasms - blood; Liver Neoplasms - therapy; Male; Medical Education; Medical prognosis; Metastasis; Middle Aged; Multivariate analysis; overall survival; Portal vein; Portal Vein - pathology; Protein-tyrosine kinase; Pyridines - administration & dosage; Pyridines - adverse effects; Retrospective Studies; Survival; Thrombosis; Thrombosis - blood; Thrombosis - therapy; transarterial chemoembolization; Treatment Outcome; Tumors; Tyrosine; Veins & arteries; Young Adult
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/j.clinthera.2019.04.036

AbstractPurposeStudies focusing on the effects of combined transcatheter arterial chemoembolization (TACE) + the tyrosine kinase inhibitor apatinib in the treatment of patients with hepatocellular carcinoma (HCC), with the location and extent of portal vein tumor thrombus (PVTT) assessed as the main variable, are rare. This multicenter, retrospective, controlled study was performed to compare the efficacy and tolerability of TACE + apatinib and TACE alone in patients with HCC and PVTT. MethodsWe retrospectively analyzed data from patients with nonresectable HCC and PVTT who underwent treatment with TACE + apatinib or TACE alone between January 2015 and January 2016. Outcomes in patients who underwent TACE + apatinib were compared with the outcomes of patients who underwent TACE alone, by using the Kaplan–Meier method, according to PVTT type: PVTT in the main portal vein (type A), PVTT in the first-order portal vein branch (type B), and PVTT in second- or lower-order portal vein branches (type C). FindingsOne hundred eighty-eight patients were included in the analysis; 85 underwent treatment with TACE + apatinib and 103 underwent treatment with TACE. TACE + apatinib was associated with a significantly greater median survival compared with TACE alone in patients with PVTT type B (12.2 vs 7.5 months; P