Ablative Chemoembolization for Hepatocellular Carcinoma: A Prospective Phase I Case-Control Comparison with
Simon Chun Ho Yu1, Stephen Lam Chan1, Kit Fai Lee1
1From the Department of Imaging and Interventional Radiology (S.C.H.Y., J.W.Y.H., C.M.C.), Vascular and Interventional Radiology Clinical Science Centre (S.C.H.Y., J.W.Y.H., C.M.C.), Department of Clinical Oncology (S.L.C., E.P.H., L.L., W.M.M.Y.), Department of Surgery (K.F.L., S.C., J.W.), and Department of Anatomical and Cellular Pathology (A.W.H.C.), Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Room 2A061, Level 2, Main Clinical Block and Trauma Centre, Shatin, Hong Kong SAR.
Ablative chemoembolization (ACE) is a safe and effective treatment for hepatocellular carcinoma (HCC), showing superior results compared to conventional transarterial chemoembolization (cTACE) in achieving complete response and prolonging progression-free survival.
Area of Science:
- Interventional Radiology
- Hepatobiliary Oncology
- Cancer Treatment Modalities
Background:
- Hepatocellular carcinoma (HCC) is a primary liver malignancy with limited treatment options.
- Conventional transarterial chemoembolization (cTACE) is a standard palliative treatment for unresectable HCC.
- There is a need for more effective and safer treatment modalities for HCC.
Purpose of the Study:
- To evaluate the feasibility, safety, and effectiveness of ablative chemoembolization (ACE) for HCC.
- To compare ACE with conventional transarterial chemoembolization (cTACE) in a matched cohort.
- To assess treatment outcomes including response rates, time to progression, and progression-free survival.
Main Methods:
- A prospective, nonrandomized phase I study comparing ACE (n=22) with cTACE (n=22) in HCC patients.
- Primary endpoints: treatment safety and tumor response.
- Secondary endpoints: time to progression, progression-free survival, and conversion to hepatectomy.
Main Results:
- ACE was feasible and safe, with no adverse effects reported.
- 100% complete response (CR) rates for both patients and tumors treated with ACE.
- Significantly longer median time to progression (28 months vs. 10 months) and progression-free survival in the ACE group (P < .001).
Conclusions:
- Ablative chemoembolization (ACE) is a feasible, safe, and well-tolerated treatment for HCC.
- ACE demonstrates high effectiveness, potentially superior to cTACE in achieving CR.
- ACE offers improved progression-free survival and conversion to hepatectomy rates compared to cTACE.
