Is Chemoembolization with PEG Drug-Eluting Embolic Agents Safe and Effective?

Chemoembolization with polyethylene glycol (PEG) drug-eluting embolic agents is a safe and effective treatment for hepatocellular carcinoma (HCC), researchers reported.

The investigators conducted a single-center, retrospective study that took place during a 20-month period. There were 302 patients (258 men) with HCC who were included in the study, and the mean patient age was 66 years ± 10. Forty-seven percent (142 patients) had Barcelona Clinic Liver Cancer stage A disease and 134 had (44.4%) stage B disease. The mean index tumor size was 36.6 mm ± 24.8.

One month after treatment, patients’ response as well as clinical and biochemical safety was evaluated using computed tomography per modified Response Evaluation Criteria In Solid Tumors (CT). The Kaplan-Meier method was used to determine progression-free and overall survival. After the 1-month follow-up, patients were then followed every 3 months. Patients were followed for a median of 11.9 months.

In 179 patients (63.2%), 1-month follow-up CT showed complete response. Partial response was seen in 63 patients (22.3%), stable disease in 16 patients (5.7%), and progressive disease in 25 patients (63.2%).

There were several complications, including postembolization syndrome in 18 patients (6%), liver abscess in 5 (1.7%), and puncture-site hematoma in 3 (1%). Additionally, 57 patients (11.6%) experienced biochemical toxicities. At 12 months, there was a progression-free survival rate of 65.9% and overall survival rate of 93.5%. There 26 of 109 eligible patients who received transplants, and they had a 57.7% rate of complete pathologic response.

“The present study demonstrates transarterial chemoembolization with PEG DEE agents loaded with 75 mg of doxorubicin to be a safe and effective treatment for intermediate-stage HCC per Barcelona Clinic Liver Cancer criteria and in liver transplantation candidates (per Milan criteria) as a bridge to transplantation,” the study’s authors wrote.

Reference

Veloso Gomes F, Oliveira JA, Correia MT, et al. Chemoembolization of hepatocellular carcinoma with drug-eluting polyethylene glycol embolic agents: single-center retrospective analysis in 302 patients. J Vasc Interv Radiol. 2018 Apr 30. pii: S1051-0443(18)30919-9. doi: 10.1016/j.jvir.2018.02.004. [Epub ahead of print].