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Radiologic response to TACE-RT as a prognostic factor in advanced HCC with macroscopic vascular invasion

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Key clinical point: The modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined radiologic response rate of transarterial chemoembolization (TACE) plus radiotherapy (RT) among patients with advanced hepatocellular carcinoma (HCC) showing macroscopic vascular invasion (MVI) is an independent prognosticator for overall survival (OS).

Main finding: Responders vs nonresponders had significantly longer median OS at 2 months (23.1 months vs 8.0 months; adjusted hazard ratio [aHR], 3.194; P < .001) and 4 months (responders vs nonresponders: 26.5 months vs 9.3 months; aHR, 4.534; P < .001).

Study details: This was a retrospective review study including 427 patients with advanced HCC and MVI who received first-line treatment with TACE plus respiratory-gated 3-dimensional conformal RT in the 2-month analysis, whereas the patient number reduced to 355 in the 4-month analysis.

Disclosures: The study was supported by the Asan Institute for Life Sciences of Asan Medical Center, Seoul, Republic of Korea. The authors declared no conflict of interests.

Source: Jung J et al. Liver Cancer. 2021 Dec 7. doi: 10.1159/000521227.

 

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Key clinical point: The modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined radiologic response rate of transarterial chemoembolization (TACE) plus radiotherapy (RT) among patients with advanced hepatocellular carcinoma (HCC) showing macroscopic vascular invasion (MVI) is an independent prognosticator for overall survival (OS).

Main finding: Responders vs nonresponders had significantly longer median OS at 2 months (23.1 months vs 8.0 months; adjusted hazard ratio [aHR], 3.194; P < .001) and 4 months (responders vs nonresponders: 26.5 months vs 9.3 months; aHR, 4.534; P < .001).

Study details: This was a retrospective review study including 427 patients with advanced HCC and MVI who received first-line treatment with TACE plus respiratory-gated 3-dimensional conformal RT in the 2-month analysis, whereas the patient number reduced to 355 in the 4-month analysis.

Disclosures: The study was supported by the Asan Institute for Life Sciences of Asan Medical Center, Seoul, Republic of Korea. The authors declared no conflict of interests.

Source: Jung J et al. Liver Cancer. 2021 Dec 7. doi: 10.1159/000521227.

 

Key clinical point: The modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined radiologic response rate of transarterial chemoembolization (TACE) plus radiotherapy (RT) among patients with advanced hepatocellular carcinoma (HCC) showing macroscopic vascular invasion (MVI) is an independent prognosticator for overall survival (OS).

Main finding: Responders vs nonresponders had significantly longer median OS at 2 months (23.1 months vs 8.0 months; adjusted hazard ratio [aHR], 3.194; P < .001) and 4 months (responders vs nonresponders: 26.5 months vs 9.3 months; aHR, 4.534; P < .001).

Study details: This was a retrospective review study including 427 patients with advanced HCC and MVI who received first-line treatment with TACE plus respiratory-gated 3-dimensional conformal RT in the 2-month analysis, whereas the patient number reduced to 355 in the 4-month analysis.

Disclosures: The study was supported by the Asan Institute for Life Sciences of Asan Medical Center, Seoul, Republic of Korea. The authors declared no conflict of interests.

Source: Jung J et al. Liver Cancer. 2021 Dec 7. doi: 10.1159/000521227.

 

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HAIC-FO outperforms sorafenib against advanced HCC in phase 3

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Key clinical point: Hepatic arterial infusion chemotherapy of infusional fluorouracil, leucovorin, and oxaliplatin (HAIC-FO) is better than sorafenib at improving survival in patients with locally advanced hepatocellular carcinoma (HCC).

Main finding: At a median follow-up of 17.1 and 19.8 months, HAIC-FO- and sorafenib-treated patients showed a median overall survival (OS) of 13.9 months (95% CI, 10.6-17.2) and 8.2 months (95% CI, 7.5-9.0), respectively (hazard ratio [HR], 0.408; P = .001), with OS improvements favoring HAIC-FO vs sorafenib in even high-risk patients (10.8 months vs 5.7 months; HR, 0.343; P < .001). Grade 3/4 adverse events were more frequent with sorafenib vs HAIC-FO (48.1% vs20.3%).

Study details: The data come from the open-label, phase 3 FOHAIC-1 trial, which included 262 systemic therapy-naive patients with locally advanced or unresectable HCC who were randomly assigned to receive either HAIC-FO (n=130) or sorafenib (n=132).

Disclosures: The National Natural Science Foundation of China sponsored the study. The authors did not report any potential conflict of interests.

Source: Lyu N et al. J Clin Oncol. 2021 Dec 14. doi: 10.1200/JCO.21.01963.

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Key clinical point: Hepatic arterial infusion chemotherapy of infusional fluorouracil, leucovorin, and oxaliplatin (HAIC-FO) is better than sorafenib at improving survival in patients with locally advanced hepatocellular carcinoma (HCC).

Main finding: At a median follow-up of 17.1 and 19.8 months, HAIC-FO- and sorafenib-treated patients showed a median overall survival (OS) of 13.9 months (95% CI, 10.6-17.2) and 8.2 months (95% CI, 7.5-9.0), respectively (hazard ratio [HR], 0.408; P = .001), with OS improvements favoring HAIC-FO vs sorafenib in even high-risk patients (10.8 months vs 5.7 months; HR, 0.343; P < .001). Grade 3/4 adverse events were more frequent with sorafenib vs HAIC-FO (48.1% vs20.3%).

Study details: The data come from the open-label, phase 3 FOHAIC-1 trial, which included 262 systemic therapy-naive patients with locally advanced or unresectable HCC who were randomly assigned to receive either HAIC-FO (n=130) or sorafenib (n=132).

Disclosures: The National Natural Science Foundation of China sponsored the study. The authors did not report any potential conflict of interests.

Source: Lyu N et al. J Clin Oncol. 2021 Dec 14. doi: 10.1200/JCO.21.01963.

Key clinical point: Hepatic arterial infusion chemotherapy of infusional fluorouracil, leucovorin, and oxaliplatin (HAIC-FO) is better than sorafenib at improving survival in patients with locally advanced hepatocellular carcinoma (HCC).

Main finding: At a median follow-up of 17.1 and 19.8 months, HAIC-FO- and sorafenib-treated patients showed a median overall survival (OS) of 13.9 months (95% CI, 10.6-17.2) and 8.2 months (95% CI, 7.5-9.0), respectively (hazard ratio [HR], 0.408; P = .001), with OS improvements favoring HAIC-FO vs sorafenib in even high-risk patients (10.8 months vs 5.7 months; HR, 0.343; P < .001). Grade 3/4 adverse events were more frequent with sorafenib vs HAIC-FO (48.1% vs20.3%).

Study details: The data come from the open-label, phase 3 FOHAIC-1 trial, which included 262 systemic therapy-naive patients with locally advanced or unresectable HCC who were randomly assigned to receive either HAIC-FO (n=130) or sorafenib (n=132).

Disclosures: The National Natural Science Foundation of China sponsored the study. The authors did not report any potential conflict of interests.

Source: Lyu N et al. J Clin Oncol. 2021 Dec 14. doi: 10.1200/JCO.21.01963.

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Atezolizumab + bevacizumab shows long-term benefits over sorafenib for unresectable HCC

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Key clinical point: Longer follow-up results confirm the survival benefits and consistent safety of first-line atezolizumab + bevacizumab vs sorafenib in patients with locally advanced or metastatic and/or unresectable hepatocellular carcinoma (HCC).

Major finding: After a 15.6-month median follow-up, the median overall survival (19.2 months vs 13.4 months; stratified hazard ratio [HR] for death, 0.66; P < .001) and progression-free survival (6.9 months vs 4.3 months; HR for death/progression, 0.65; P < .001) were higher with atezolizumab + bevacizumab vs sorafenib. Treatment-related grade 3/4 adverse events occurred in 43% vs 46% of patients receiving atezolizumab + bevacizumab vs sorafenib.

Study details: Findings are from a post hoc analysis of the phase 3 IMbrave150 trial including 501 treatment-naïve patients with locally advanced or metastatic and/or unresectable HCC. Patients were randomly assigned to atezolizumab + bevacizumab or sorafenib.

Disclosures: This study was funded by F. Hoffman-La Roche (FHLR)/Genentech. All investigators reported receiving financial or nonfinancial support, providing expert testimony, being an employee of, or holding shares/stocks in various pharmaceutical companies including FHLR/Genentech.

Source: Cheng AL et al. J Hepatol. 2021 Dec 10. doi: 10.1016/j.jhep.2021.11.030.

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Key clinical point: Longer follow-up results confirm the survival benefits and consistent safety of first-line atezolizumab + bevacizumab vs sorafenib in patients with locally advanced or metastatic and/or unresectable hepatocellular carcinoma (HCC).

Major finding: After a 15.6-month median follow-up, the median overall survival (19.2 months vs 13.4 months; stratified hazard ratio [HR] for death, 0.66; P < .001) and progression-free survival (6.9 months vs 4.3 months; HR for death/progression, 0.65; P < .001) were higher with atezolizumab + bevacizumab vs sorafenib. Treatment-related grade 3/4 adverse events occurred in 43% vs 46% of patients receiving atezolizumab + bevacizumab vs sorafenib.

Study details: Findings are from a post hoc analysis of the phase 3 IMbrave150 trial including 501 treatment-naïve patients with locally advanced or metastatic and/or unresectable HCC. Patients were randomly assigned to atezolizumab + bevacizumab or sorafenib.

Disclosures: This study was funded by F. Hoffman-La Roche (FHLR)/Genentech. All investigators reported receiving financial or nonfinancial support, providing expert testimony, being an employee of, or holding shares/stocks in various pharmaceutical companies including FHLR/Genentech.

Source: Cheng AL et al. J Hepatol. 2021 Dec 10. doi: 10.1016/j.jhep.2021.11.030.

Key clinical point: Longer follow-up results confirm the survival benefits and consistent safety of first-line atezolizumab + bevacizumab vs sorafenib in patients with locally advanced or metastatic and/or unresectable hepatocellular carcinoma (HCC).

Major finding: After a 15.6-month median follow-up, the median overall survival (19.2 months vs 13.4 months; stratified hazard ratio [HR] for death, 0.66; P < .001) and progression-free survival (6.9 months vs 4.3 months; HR for death/progression, 0.65; P < .001) were higher with atezolizumab + bevacizumab vs sorafenib. Treatment-related grade 3/4 adverse events occurred in 43% vs 46% of patients receiving atezolizumab + bevacizumab vs sorafenib.

Study details: Findings are from a post hoc analysis of the phase 3 IMbrave150 trial including 501 treatment-naïve patients with locally advanced or metastatic and/or unresectable HCC. Patients were randomly assigned to atezolizumab + bevacizumab or sorafenib.

Disclosures: This study was funded by F. Hoffman-La Roche (FHLR)/Genentech. All investigators reported receiving financial or nonfinancial support, providing expert testimony, being an employee of, or holding shares/stocks in various pharmaceutical companies including FHLR/Genentech.

Source: Cheng AL et al. J Hepatol. 2021 Dec 10. doi: 10.1016/j.jhep.2021.11.030.

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No survival benefits with first-line nivolumab vs sorafenib in advanced HCC

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Key clinical point: First-line nivolumab treatment did not improve overall survival in patients with advanced hepatocellular carcinoma (HCC) compared with sorafenib.

Major finding: At a minimum follow-up of 22.8 months, nivolumab vs sorafenib did not meet the prespecified significance boundary for superior overall survival (16.4 months vs 14.7 months; hazard ratio, 0.85; P = .075).

Study details: Findings are from the phase 3 CheckMate 459 trial including 743 adult patients with advanced HCC randomly assigned to receive either nivolumab (n=371) or sorafenib (n=372).

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Ono Pharmaceutical. Some investigators including the lead author reported receiving grants and fees from, participation on data safety monitoring board or advisory boards for, owning stocks in, and being an employee of various pharmaceutical companies, including BMS and Ono Pharmaceutical.

Source: Yau T et al. Lancet Oncol. 2021 Dec 13. doi: 10.1016/S1470-2045(21)00604-5.

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Key clinical point: First-line nivolumab treatment did not improve overall survival in patients with advanced hepatocellular carcinoma (HCC) compared with sorafenib.

Major finding: At a minimum follow-up of 22.8 months, nivolumab vs sorafenib did not meet the prespecified significance boundary for superior overall survival (16.4 months vs 14.7 months; hazard ratio, 0.85; P = .075).

Study details: Findings are from the phase 3 CheckMate 459 trial including 743 adult patients with advanced HCC randomly assigned to receive either nivolumab (n=371) or sorafenib (n=372).

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Ono Pharmaceutical. Some investigators including the lead author reported receiving grants and fees from, participation on data safety monitoring board or advisory boards for, owning stocks in, and being an employee of various pharmaceutical companies, including BMS and Ono Pharmaceutical.

Source: Yau T et al. Lancet Oncol. 2021 Dec 13. doi: 10.1016/S1470-2045(21)00604-5.

Key clinical point: First-line nivolumab treatment did not improve overall survival in patients with advanced hepatocellular carcinoma (HCC) compared with sorafenib.

Major finding: At a minimum follow-up of 22.8 months, nivolumab vs sorafenib did not meet the prespecified significance boundary for superior overall survival (16.4 months vs 14.7 months; hazard ratio, 0.85; P = .075).

Study details: Findings are from the phase 3 CheckMate 459 trial including 743 adult patients with advanced HCC randomly assigned to receive either nivolumab (n=371) or sorafenib (n=372).

Disclosures: This study was supported by Bristol Myers Squibb (BMS) and Ono Pharmaceutical. Some investigators including the lead author reported receiving grants and fees from, participation on data safety monitoring board or advisory boards for, owning stocks in, and being an employee of various pharmaceutical companies, including BMS and Ono Pharmaceutical.

Source: Yau T et al. Lancet Oncol. 2021 Dec 13. doi: 10.1016/S1470-2045(21)00604-5.

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Advanced HCC: Data spanning 15 years shows significant improvement in clinical outcomes with sorafenib

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Key clinical point: Between 2005 and 2019, sorafenib therapy has led to improvement in clinical outcomes among treatment-naïve patients with advanced hepatocellular carcinoma (HCC) in concurrence with a decrease in the median duration of therapy.

Main finding: While the median duration of therapy decreased by 53%, from 23.1 weeks to 12.2 weeks (P = .003) over the study period, the median overall survival increased by 4.5 months (P = .048) and the objective response rate increased by 6 months (P = .003).

Study details: This was an analysis of 16 randomized clinical trials (9 phase 3 and 7 phase 2) conducted from 2005-2019, wherein sorafenib was administered to 4,086 patients with advanced HCC naïve to systemic therapy to compare its effect relative to another systemic therapy or placebo.

Disclosures: The study received grants from the National Institutes of Health. M Yarchoan declared receiving research grants from or working as a consultant for various organizations.

Source: Brown TJ et al. Gastrointest Tumors. 2021 Dec 22. doi: 10.1159/000521625.

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Key clinical point: Between 2005 and 2019, sorafenib therapy has led to improvement in clinical outcomes among treatment-naïve patients with advanced hepatocellular carcinoma (HCC) in concurrence with a decrease in the median duration of therapy.

Main finding: While the median duration of therapy decreased by 53%, from 23.1 weeks to 12.2 weeks (P = .003) over the study period, the median overall survival increased by 4.5 months (P = .048) and the objective response rate increased by 6 months (P = .003).

Study details: This was an analysis of 16 randomized clinical trials (9 phase 3 and 7 phase 2) conducted from 2005-2019, wherein sorafenib was administered to 4,086 patients with advanced HCC naïve to systemic therapy to compare its effect relative to another systemic therapy or placebo.

Disclosures: The study received grants from the National Institutes of Health. M Yarchoan declared receiving research grants from or working as a consultant for various organizations.

Source: Brown TJ et al. Gastrointest Tumors. 2021 Dec 22. doi: 10.1159/000521625.

Key clinical point: Between 2005 and 2019, sorafenib therapy has led to improvement in clinical outcomes among treatment-naïve patients with advanced hepatocellular carcinoma (HCC) in concurrence with a decrease in the median duration of therapy.

Main finding: While the median duration of therapy decreased by 53%, from 23.1 weeks to 12.2 weeks (P = .003) over the study period, the median overall survival increased by 4.5 months (P = .048) and the objective response rate increased by 6 months (P = .003).

Study details: This was an analysis of 16 randomized clinical trials (9 phase 3 and 7 phase 2) conducted from 2005-2019, wherein sorafenib was administered to 4,086 patients with advanced HCC naïve to systemic therapy to compare its effect relative to another systemic therapy or placebo.

Disclosures: The study received grants from the National Institutes of Health. M Yarchoan declared receiving research grants from or working as a consultant for various organizations.

Source: Brown TJ et al. Gastrointest Tumors. 2021 Dec 22. doi: 10.1159/000521625.

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How can the patient response and outcome to drug-eluting bead TACE for HCC be predicted?

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Key clinical point: Having undergone drug-eluting bead transarterial chemoembolization (DEB-TACE), treatment response and disease-free survival (DFS) in patients with hepatocellular carcinoma (HCC) could be predicted by MRI signal intensity in the hepatobiliary phase (HBP) and serum alpha-fetoprotein (AFP) levels, respectively.

Main finding: The only significant predictive factors of noncomplete response and short DFS were signal intensity heterogeneity in the HBP (adjusted odds ratio, 4.807; P = .048) and elevated serum AFP levels (≥30 ng/mL; adjusted hazard ratio, 2.916; P = .040), respectively.

Study details: This was a preliminary single-center retrospective study including 55 treatment-naive patients who underwent DEB-TACE for HCC.

Disclosures: The study was sponsored by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government. The authors reported no conflict of interests.

Source: Lee JY et al. Sci Rep. 2021 Dec 15. doi: 10.1038/s41598-021-01839-6.

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Key clinical point: Having undergone drug-eluting bead transarterial chemoembolization (DEB-TACE), treatment response and disease-free survival (DFS) in patients with hepatocellular carcinoma (HCC) could be predicted by MRI signal intensity in the hepatobiliary phase (HBP) and serum alpha-fetoprotein (AFP) levels, respectively.

Main finding: The only significant predictive factors of noncomplete response and short DFS were signal intensity heterogeneity in the HBP (adjusted odds ratio, 4.807; P = .048) and elevated serum AFP levels (≥30 ng/mL; adjusted hazard ratio, 2.916; P = .040), respectively.

Study details: This was a preliminary single-center retrospective study including 55 treatment-naive patients who underwent DEB-TACE for HCC.

Disclosures: The study was sponsored by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government. The authors reported no conflict of interests.

Source: Lee JY et al. Sci Rep. 2021 Dec 15. doi: 10.1038/s41598-021-01839-6.

Key clinical point: Having undergone drug-eluting bead transarterial chemoembolization (DEB-TACE), treatment response and disease-free survival (DFS) in patients with hepatocellular carcinoma (HCC) could be predicted by MRI signal intensity in the hepatobiliary phase (HBP) and serum alpha-fetoprotein (AFP) levels, respectively.

Main finding: The only significant predictive factors of noncomplete response and short DFS were signal intensity heterogeneity in the HBP (adjusted odds ratio, 4.807; P = .048) and elevated serum AFP levels (≥30 ng/mL; adjusted hazard ratio, 2.916; P = .040), respectively.

Study details: This was a preliminary single-center retrospective study including 55 treatment-naive patients who underwent DEB-TACE for HCC.

Disclosures: The study was sponsored by the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government. The authors reported no conflict of interests.

Source: Lee JY et al. Sci Rep. 2021 Dec 15. doi: 10.1038/s41598-021-01839-6.

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Microwave ablation as a possible real-world replacement for radiofrequency ablation in HCC

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Key clinical point: Compared with radiofrequency ablation (RFA), microwave ablation (MWA) effectuates better 1- and 2-year disease-free survival (DFS) along with a lower risk of major complications in patients with hepatocellular carcinoma (HCC).

Main finding: Although both ablation therapies led to a similar 2-year overall survival (P = .573), MWA achieved better 1-year DFS (79.7% vs 60.7%; P = .035) and 2-year DFS (72.5% vs 45.4%; P = .02) rates than RFA. Concurrently, MWA showed a lower rate of major complications than RFA (14% vs 29%; P = .043).

Study details: Findings are from a retrospective cohort study involving 150 patients with HCC, including treatment-naïve and recurrent HCC, who were treated with either RFA (n=100) or MWA (n=50).

Disclosures: The study was sponsored by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education. No conflict of interests was reported by the authors.

Source: Lee SK et al. J Clin Med. 2022 Jan 7. doi: 10.3390/jcm11020302.

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Key clinical point: Compared with radiofrequency ablation (RFA), microwave ablation (MWA) effectuates better 1- and 2-year disease-free survival (DFS) along with a lower risk of major complications in patients with hepatocellular carcinoma (HCC).

Main finding: Although both ablation therapies led to a similar 2-year overall survival (P = .573), MWA achieved better 1-year DFS (79.7% vs 60.7%; P = .035) and 2-year DFS (72.5% vs 45.4%; P = .02) rates than RFA. Concurrently, MWA showed a lower rate of major complications than RFA (14% vs 29%; P = .043).

Study details: Findings are from a retrospective cohort study involving 150 patients with HCC, including treatment-naïve and recurrent HCC, who were treated with either RFA (n=100) or MWA (n=50).

Disclosures: The study was sponsored by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education. No conflict of interests was reported by the authors.

Source: Lee SK et al. J Clin Med. 2022 Jan 7. doi: 10.3390/jcm11020302.

Key clinical point: Compared with radiofrequency ablation (RFA), microwave ablation (MWA) effectuates better 1- and 2-year disease-free survival (DFS) along with a lower risk of major complications in patients with hepatocellular carcinoma (HCC).

Main finding: Although both ablation therapies led to a similar 2-year overall survival (P = .573), MWA achieved better 1-year DFS (79.7% vs 60.7%; P = .035) and 2-year DFS (72.5% vs 45.4%; P = .02) rates than RFA. Concurrently, MWA showed a lower rate of major complications than RFA (14% vs 29%; P = .043).

Study details: Findings are from a retrospective cohort study involving 150 patients with HCC, including treatment-naïve and recurrent HCC, who were treated with either RFA (n=100) or MWA (n=50).

Disclosures: The study was sponsored by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education. No conflict of interests was reported by the authors.

Source: Lee SK et al. J Clin Med. 2022 Jan 7. doi: 10.3390/jcm11020302.

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Periportal HCC: Long-term outcome of radiofrequency ablation

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Key clinical point: First-line radiofrequency ablation (RFA) is associated with worse long-term therapeutic outcomes for single periportal hepatocellular carcinoma (HCC) than for single nonperiportal HCC.

Main finding: At 1 and 5 years, periportal vs nonperiportal HCC was associated with significantly higher local tumor progression rates (15.7% and 46.9% vs 6.0% and 28.7%, respectively; P = .007) and worse overall survival rates (81.3% and 42.9% vs 99.3% and 78.1%, respectively; P < .0001).

Study details: The data come from a retrospective study involving 233 patients with HCC, either periportal (n=56) or nonperiportal (n=177), who underwent percutaneous RFA alone or combined with transarterial chemoembolization as first-line treatment.

Disclosures: The authors reported no funding source or conflict of interests.

Source: Cao S et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00442-2.

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Key clinical point: First-line radiofrequency ablation (RFA) is associated with worse long-term therapeutic outcomes for single periportal hepatocellular carcinoma (HCC) than for single nonperiportal HCC.

Main finding: At 1 and 5 years, periportal vs nonperiportal HCC was associated with significantly higher local tumor progression rates (15.7% and 46.9% vs 6.0% and 28.7%, respectively; P = .007) and worse overall survival rates (81.3% and 42.9% vs 99.3% and 78.1%, respectively; P < .0001).

Study details: The data come from a retrospective study involving 233 patients with HCC, either periportal (n=56) or nonperiportal (n=177), who underwent percutaneous RFA alone or combined with transarterial chemoembolization as first-line treatment.

Disclosures: The authors reported no funding source or conflict of interests.

Source: Cao S et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00442-2.

Key clinical point: First-line radiofrequency ablation (RFA) is associated with worse long-term therapeutic outcomes for single periportal hepatocellular carcinoma (HCC) than for single nonperiportal HCC.

Main finding: At 1 and 5 years, periportal vs nonperiportal HCC was associated with significantly higher local tumor progression rates (15.7% and 46.9% vs 6.0% and 28.7%, respectively; P = .007) and worse overall survival rates (81.3% and 42.9% vs 99.3% and 78.1%, respectively; P < .0001).

Study details: The data come from a retrospective study involving 233 patients with HCC, either periportal (n=56) or nonperiportal (n=177), who underwent percutaneous RFA alone or combined with transarterial chemoembolization as first-line treatment.

Disclosures: The authors reported no funding source or conflict of interests.

Source: Cao S et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00442-2.

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HIAC vs TACE: The better initial therapy for infiltrative HCC?

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Fri, 03/25/2022 - 22:21

Key clinical point: As initial treatment, hepatic arterial infusion chemotherapy (HAIC) effectuates a greater survival and radiological response than transarterial chemoembolization (TACE) among patients with infiltrative hepatocellular carcinoma (HCC).

Main finding: HIAC vs TACE led to a longer median overall survival (13.3 months vs 10.8 months; P = .043) and progression-free survival (7.8 months vs 4.0 months; P = .035) along with higher objective response (34.8% vs 11.8%; P = .001) and disease control (54.3% vs 36.8%; P = .028) rates.

Study details: Findings are from a retrospective real-world study including 160 adult patients with large infiltrative HCCs who underwent either HAIC (n=92) or TACE (n=68) as initial treatment.

Disclosures: The authors declared receiving no financial assistance for the study and having no potential conflict of interests.

Source: An C et al. Front Oncol. 2021 Dec 16. doi: 10.3389/fonc.2021.747496.

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Key clinical point: As initial treatment, hepatic arterial infusion chemotherapy (HAIC) effectuates a greater survival and radiological response than transarterial chemoembolization (TACE) among patients with infiltrative hepatocellular carcinoma (HCC).

Main finding: HIAC vs TACE led to a longer median overall survival (13.3 months vs 10.8 months; P = .043) and progression-free survival (7.8 months vs 4.0 months; P = .035) along with higher objective response (34.8% vs 11.8%; P = .001) and disease control (54.3% vs 36.8%; P = .028) rates.

Study details: Findings are from a retrospective real-world study including 160 adult patients with large infiltrative HCCs who underwent either HAIC (n=92) or TACE (n=68) as initial treatment.

Disclosures: The authors declared receiving no financial assistance for the study and having no potential conflict of interests.

Source: An C et al. Front Oncol. 2021 Dec 16. doi: 10.3389/fonc.2021.747496.

Key clinical point: As initial treatment, hepatic arterial infusion chemotherapy (HAIC) effectuates a greater survival and radiological response than transarterial chemoembolization (TACE) among patients with infiltrative hepatocellular carcinoma (HCC).

Main finding: HIAC vs TACE led to a longer median overall survival (13.3 months vs 10.8 months; P = .043) and progression-free survival (7.8 months vs 4.0 months; P = .035) along with higher objective response (34.8% vs 11.8%; P = .001) and disease control (54.3% vs 36.8%; P = .028) rates.

Study details: Findings are from a retrospective real-world study including 160 adult patients with large infiltrative HCCs who underwent either HAIC (n=92) or TACE (n=68) as initial treatment.

Disclosures: The authors declared receiving no financial assistance for the study and having no potential conflict of interests.

Source: An C et al. Front Oncol. 2021 Dec 16. doi: 10.3389/fonc.2021.747496.

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mRECIST objective response and early tumor shrinkage predict survival in sorafenib-treated HCC

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Fri, 03/25/2022 - 22:20

Key clinical point: Modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined objective response (OR) and early tumor shrinkage (ETS) may serve as independent prognostic factors for overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) on sorafenib monotherapy.

Main finding: OR assessed by mRECIST (adjusted hazard ratio [aHR], 0.32; P < .001) and ETS (aHR, 0.44; P < .001) were independent prognostic factors for OS. A longer median OS was shown by responders vs nonresponders (30.3 months vs 11.4 months; P < .001) and by patients with ETS ≥20% vs those with ETS <20% (22.1 months vs 11.4 months; P < .001).

Study details: This was a post hoc analysis of data from the phase 2 SORAMIC trial and included 115 patients with advanced HCC receiving sorafenib monotherapy.

Disclosures: The study was sponsored by Sirtex Medical and Bayer Healthcare. Some of the authors declared receiving personal fees and research grants from various sources including Bayer and Sirtex.

Source: Öcal O et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00439-x.

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Key clinical point: Modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined objective response (OR) and early tumor shrinkage (ETS) may serve as independent prognostic factors for overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) on sorafenib monotherapy.

Main finding: OR assessed by mRECIST (adjusted hazard ratio [aHR], 0.32; P < .001) and ETS (aHR, 0.44; P < .001) were independent prognostic factors for OS. A longer median OS was shown by responders vs nonresponders (30.3 months vs 11.4 months; P < .001) and by patients with ETS ≥20% vs those with ETS <20% (22.1 months vs 11.4 months; P < .001).

Study details: This was a post hoc analysis of data from the phase 2 SORAMIC trial and included 115 patients with advanced HCC receiving sorafenib monotherapy.

Disclosures: The study was sponsored by Sirtex Medical and Bayer Healthcare. Some of the authors declared receiving personal fees and research grants from various sources including Bayer and Sirtex.

Source: Öcal O et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00439-x.

Key clinical point: Modified Response Evaluation Criteria in Solid Tumors (mRECIST)-determined objective response (OR) and early tumor shrinkage (ETS) may serve as independent prognostic factors for overall survival (OS) in patients with advanced hepatocellular carcinoma (HCC) on sorafenib monotherapy.

Main finding: OR assessed by mRECIST (adjusted hazard ratio [aHR], 0.32; P < .001) and ETS (aHR, 0.44; P < .001) were independent prognostic factors for OS. A longer median OS was shown by responders vs nonresponders (30.3 months vs 11.4 months; P < .001) and by patients with ETS ≥20% vs those with ETS <20% (22.1 months vs 11.4 months; P < .001).

Study details: This was a post hoc analysis of data from the phase 2 SORAMIC trial and included 115 patients with advanced HCC receiving sorafenib monotherapy.

Disclosures: The study was sponsored by Sirtex Medical and Bayer Healthcare. Some of the authors declared receiving personal fees and research grants from various sources including Bayer and Sirtex.

Source: Öcal O et al. Cancer Imaging. 2022 Jan 4. doi: 10.1186/s40644-021-00439-x.

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