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Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study
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...
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| Published in: | Clinical therapeutics 2019-08, Vol.41 (8), p.1463-1476 |
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| creator | 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 |
| description | 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 |
| doi_str_mv | 10.1016/j.clinthera.2019.04.036 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2258160702</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0149291819302395</els_id><sourcerecordid>2258160702</sourcerecordid><originalsourceid>FETCH-LOGICAL-c454t-7adc9bcbbe8bf104719bdcac557c68f22e7adb3e1ce41aef40d2ac1c67af33793</originalsourceid><addsrcrecordid>eNqNkk1vEzEQhlcIRNPCXwBLXLhk8cd-mQNSFEGLVERFw8fN8npnFYddO9jeSuHn8EuZVUoOPXHyHJ73Hc-8k2UvGc0ZZdWbXW4G69IWgs45ZTKnRU5F9ShbsKaWS8aKH4-zBWWFXHLJmrPsPMYdpVTIkj_NzgQTVPBaLrI_q71O1tmWrP3YWgcd-W7TlmyCdlGHBMHqgay3MHoYWz_Y34h7R6wjN1iBS_EouAI08gaGYRp0IGsdjHV-1ES7jtz4kNDmG6BsM40-kM02YL8pviUr8mkakjVoBYF8gRR83INJ9g7IbZq6w7PsSa-HCM_v34vs64f3m_XV8vrz5cf16nppirJIy1p3RrambaFpe0aLmsm2M9qUZW2qpucckGgFMAMF09AXtOPaMFPVuheiluIie3303Qf_a4KY1GjjPJB24KeoOC8bVtGackRfPUB3fgoOf4dUwwuKTUuk6iNlcKQYoFf7YEcdDopRNceoduoUo5pjVLRQGCMqX9z7T-0I3Un3LzcEVkcAcCF3FoKKBsMw0NmAu1Odt__R5N0Dj5mzRg8_4QDxNBFTkSuqbudrmo-JSYErkKX4C2zXzBk</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2282405575</pqid></control><display><type>article</type><title>Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study</title><source>ScienceDirect Freedom Collection</source><creator>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</creator><creatorcontrib>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</creatorcontrib><description>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 < 0.001) or type C (13.7 vs 7.2 months; P = 0.006). Along with treatment strategies and α-fetoprotein, the absence of main PVTT was an independent factor predictive of survival on uni- and multivariate analysis. Apatinib-related grade 3 adverse events occurred in 27 patients (31.8%). ImplicationsTACE + apatinib can be of potential benefit to patients with advanced HCC with tumor thrombus in the first- and lower-order portal vein branches. Adverse events with apatinib need to be monitored during application, despite the manageable appearance.</description><identifier>ISSN: 0149-2918</identifier><identifier>EISSN: 1879-114X</identifier><identifier>DOI: 10.1016/j.clinthera.2019.04.036</identifier><identifier>PMID: 31303279</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>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</subject><ispartof>Clinical therapeutics, 2019-08, Vol.41 (8), p.1463-1476</ispartof><rights>2019</rights><rights>Copyright © 2019. Published by Elsevier Inc.</rights><rights>Copyright Elsevier Limited Aug 2019</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-7adc9bcbbe8bf104719bdcac557c68f22e7adb3e1ce41aef40d2ac1c67af33793</citedby><cites>FETCH-LOGICAL-c454t-7adc9bcbbe8bf104719bdcac557c68f22e7adb3e1ce41aef40d2ac1c67af33793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31303279$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fan, Wenzhe, MD</creatorcontrib><creatorcontrib>Yuan, Guosheng, PhD</creatorcontrib><creatorcontrib>Fan, Huishuang, MSc</creatorcontrib><creatorcontrib>Li, Fuliang, MSc</creatorcontrib><creatorcontrib>Wu, Yanqin, MD</creatorcontrib><creatorcontrib>Zhao, Yue, MD</creatorcontrib><creatorcontrib>Yao, Wang, MD</creatorcontrib><creatorcontrib>Wang, Yu, MD</creatorcontrib><creatorcontrib>Xue, Miao, MD</creatorcontrib><creatorcontrib>Yang, Jianyong, MD</creatorcontrib><creatorcontrib>Li, Jiaping, MD</creatorcontrib><title>Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study</title><title>Clinical therapeutics</title><addtitle>Clin Ther</addtitle><description>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 < 0.001) or type C (13.7 vs 7.2 months; P = 0.006). Along with treatment strategies and α-fetoprotein, the absence of main PVTT was an independent factor predictive of survival on uni- and multivariate analysis. Apatinib-related grade 3 adverse events occurred in 27 patients (31.8%). ImplicationsTACE + apatinib can be of potential benefit to patients with advanced HCC with tumor thrombus in the first- and lower-order portal vein branches. Adverse events with apatinib need to be monitored during application, despite the manageable appearance.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>alpha-Fetoproteins - analysis</subject><subject>Antineoplastic Agents - administration & dosage</subject><subject>Antineoplastic Agents - adverse effects</subject><subject>apatinib</subject><subject>Blood clots</subject><subject>Cancer therapies</subject><subject>Carcinoma, Hepatocellular - blood</subject><subject>Carcinoma, Hepatocellular - therapy</subject><subject>Chemoembolization</subject><subject>Chemoembolization, Therapeutic</subject><subject>Chemotherapy</subject><subject>Enzyme inhibitors</subject><subject>Female</subject><subject>Gastric cancer</subject><subject>Hepatocellular carcinoma</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Internal Medicine</subject><subject>Kinases</subject><subject>Liver cancer</subject><subject>Liver Neoplasms - blood</subject><subject>Liver Neoplasms - therapy</subject><subject>Male</subject><subject>Medical Education</subject><subject>Medical prognosis</subject><subject>Metastasis</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>overall survival</subject><subject>Portal vein</subject><subject>Portal Vein - pathology</subject><subject>Protein-tyrosine kinase</subject><subject>Pyridines - administration & dosage</subject><subject>Pyridines - adverse effects</subject><subject>Retrospective Studies</subject><subject>Survival</subject><subject>Thrombosis</subject><subject>Thrombosis - blood</subject><subject>Thrombosis - therapy</subject><subject>transarterial chemoembolization</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Tyrosine</subject><subject>Veins & arteries</subject><subject>Young Adult</subject><issn>0149-2918</issn><issn>1879-114X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqNkk1vEzEQhlcIRNPCXwBLXLhk8cd-mQNSFEGLVERFw8fN8npnFYddO9jeSuHn8EuZVUoOPXHyHJ73Hc-8k2UvGc0ZZdWbXW4G69IWgs45ZTKnRU5F9ShbsKaWS8aKH4-zBWWFXHLJmrPsPMYdpVTIkj_NzgQTVPBaLrI_q71O1tmWrP3YWgcd-W7TlmyCdlGHBMHqgay3MHoYWz_Y34h7R6wjN1iBS_EouAI08gaGYRp0IGsdjHV-1ES7jtz4kNDmG6BsM40-kM02YL8pviUr8mkakjVoBYF8gRR83INJ9g7IbZq6w7PsSa-HCM_v34vs64f3m_XV8vrz5cf16nppirJIy1p3RrambaFpe0aLmsm2M9qUZW2qpucckGgFMAMF09AXtOPaMFPVuheiluIie3303Qf_a4KY1GjjPJB24KeoOC8bVtGackRfPUB3fgoOf4dUwwuKTUuk6iNlcKQYoFf7YEcdDopRNceoduoUo5pjVLRQGCMqX9z7T-0I3Un3LzcEVkcAcCF3FoKKBsMw0NmAu1Odt__R5N0Dj5mzRg8_4QDxNBFTkSuqbudrmo-JSYErkKX4C2zXzBk</recordid><startdate>20190801</startdate><enddate>20190801</enddate><creator>Fan, Wenzhe, MD</creator><creator>Yuan, Guosheng, PhD</creator><creator>Fan, Huishuang, MSc</creator><creator>Li, Fuliang, MSc</creator><creator>Wu, Yanqin, MD</creator><creator>Zhao, Yue, MD</creator><creator>Yao, Wang, MD</creator><creator>Wang, Yu, MD</creator><creator>Xue, Miao, MD</creator><creator>Yang, Jianyong, MD</creator><creator>Li, Jiaping, MD</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88C</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M0T</scope><scope>M1P</scope><scope>M2O</scope><scope>M7N</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20190801</creationdate><title>Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-7adc9bcbbe8bf104719bdcac557c68f22e7adb3e1ce41aef40d2ac1c67af33793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>alpha-Fetoproteins - analysis</topic><topic>Antineoplastic Agents - administration & dosage</topic><topic>Antineoplastic Agents - adverse effects</topic><topic>apatinib</topic><topic>Blood clots</topic><topic>Cancer therapies</topic><topic>Carcinoma, Hepatocellular - blood</topic><topic>Carcinoma, Hepatocellular - therapy</topic><topic>Chemoembolization</topic><topic>Chemoembolization, Therapeutic</topic><topic>Chemotherapy</topic><topic>Enzyme inhibitors</topic><topic>Female</topic><topic>Gastric cancer</topic><topic>Hepatocellular carcinoma</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Internal Medicine</topic><topic>Kinases</topic><topic>Liver cancer</topic><topic>Liver Neoplasms - blood</topic><topic>Liver Neoplasms - therapy</topic><topic>Male</topic><topic>Medical Education</topic><topic>Medical prognosis</topic><topic>Metastasis</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>overall survival</topic><topic>Portal vein</topic><topic>Portal Vein - pathology</topic><topic>Protein-tyrosine kinase</topic><topic>Pyridines - administration & dosage</topic><topic>Pyridines - adverse effects</topic><topic>Retrospective Studies</topic><topic>Survival</topic><topic>Thrombosis</topic><topic>Thrombosis - blood</topic><topic>Thrombosis - therapy</topic><topic>transarterial chemoembolization</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Tyrosine</topic><topic>Veins & arteries</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fan, Wenzhe, MD</creatorcontrib><creatorcontrib>Yuan, Guosheng, PhD</creatorcontrib><creatorcontrib>Fan, Huishuang, MSc</creatorcontrib><creatorcontrib>Li, Fuliang, MSc</creatorcontrib><creatorcontrib>Wu, Yanqin, MD</creatorcontrib><creatorcontrib>Zhao, Yue, MD</creatorcontrib><creatorcontrib>Yao, Wang, MD</creatorcontrib><creatorcontrib>Wang, Yu, MD</creatorcontrib><creatorcontrib>Xue, Miao, MD</creatorcontrib><creatorcontrib>Yang, Jianyong, MD</creatorcontrib><creatorcontrib>Li, Jiaping, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>ProQuest research library</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fan, Wenzhe, MD</au><au>Yuan, Guosheng, PhD</au><au>Fan, Huishuang, MSc</au><au>Li, Fuliang, MSc</au><au>Wu, Yanqin, MD</au><au>Zhao, Yue, MD</au><au>Yao, Wang, MD</au><au>Wang, Yu, MD</au><au>Xue, Miao, MD</au><au>Yang, Jianyong, MD</au><au>Li, Jiaping, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study</atitle><jtitle>Clinical therapeutics</jtitle><addtitle>Clin Ther</addtitle><date>2019-08-01</date><risdate>2019</risdate><volume>41</volume><issue>8</issue><spage>1463</spage><epage>1476</epage><pages>1463-1476</pages><issn>0149-2918</issn><eissn>1879-114X</eissn><abstract>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 < 0.001) or type C (13.7 vs 7.2 months; P = 0.006). Along with treatment strategies and α-fetoprotein, the absence of main PVTT was an independent factor predictive of survival on uni- and multivariate analysis. Apatinib-related grade 3 adverse events occurred in 27 patients (31.8%). ImplicationsTACE + apatinib can be of potential benefit to patients with advanced HCC with tumor thrombus in the first- and lower-order portal vein branches. Adverse events with apatinib need to be monitored during application, despite the manageable appearance.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31303279</pmid><doi>10.1016/j.clinthera.2019.04.036</doi><tpages>14</tpages></addata></record> |
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| ispartof | Clinical therapeutics, 2019-08, Vol.41 (8), p.1463-1476 |
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| 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 |
| title | Apatinib Combined With Transarterial Chemoembolization in Patients With Hepatocellular Carcinoma and Portal Vein Tumor Thrombus: A Multicenter Retrospective Study |
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