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Published on: January 25, 2015
HAIC as a potential therapy for esophageal cancer patients with liver metastasis: a retrospective cohort study
Fengxiao Dong1, Guang Cao2, Zhihao Lu1
1Department of Gastrointestinal Oncology, Peking University Cancer Hospital, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China.
Insights
Hepatic arterial infusion chemotherapy (HAIC) shows promise for esophageal squamous cell carcinoma (ESCC) with liver metastases (LM). This regional therapy demonstrated a 48.5% objective response rate and was generally well-tolerated, suggesting it as a viable treatment option.
Area of Science:
- Oncology
- Gastroenterology
- Medical Oncology
Background:
- Esophageal squamous cell carcinoma (ESCC) frequently metastasizes to the liver (LM).
- Effective regional therapies for ESCC with LM are crucial for improving patient outcomes.
Purpose of the Study:
- To evaluate the efficacy and safety of Hepatic Arterial Infusion Chemotherapy (HAIC) in patients with ESCC and liver metastases.
- To assess treatment response, survival, and adverse events associated with HAIC therapy.
Main Methods:
- A single-arm, historical cohort study involving 33 patients with ESCC and LM.
- Patients received catheterized HAIC therapy over a median of three sessions.
- Retrospective analysis of liver progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), overall survival (OS), and adverse events (AEs).
Main Results:
- The ORR was 48.5% (16/33 patients achieved partial response), and the DCR was 93.9%.
- Median liver PFS was 4.8 months, and median OS was 6.4 months.
- Grade 3 adverse events included nausea (30.0%) and abdominal pain (9.1%); overall, HAIC was deemed acceptable and tolerable.
Conclusions:
- HAIC can be considered a potentially effective regional therapy for ESCC patients with liver metastases.
- The treatment demonstrated a notable response rate and acceptable safety profile in this cohort.
- Further research may explore optimizing HAIC regimens for improved outcomes in ESCC with LM.
Methods:
This was a single-arm historical cohort study of ESCC patients with synchronous or heterochronous LM between December 2014 and July 2021 at the Department of Gastrointestinal Oncology. The patients were treated with HAIC for LM, and regular image assessments were performed according to the judgment of the interventional physician. Liver progression-free survival (PFS), liver objective response rate (ORR), liver disease control rate (DCR), overall survival (OS), adverse events (AEs), treatment information, and basic characteristics were observed retrospectively.
Results:
Overall, a total of 33 patients were enrolled in this study. All included patients received catheterized HAIC therapy, with a median of three (ranging from 2 to 6) sessions. The treatment response of liver metastatic lesions included partial response (PR) in 16 (48.5%) patients, stable disease (SD) in 15 (45.5%) patients, and progressive disease (PD) in two (6.1%) patients, for an ORR of 48.5% and a DCR of 93.9%. The median liver PFS was 4.8 months (95% confidence interval (CI): 3.0-6.6 months), and the median OS was 6.4 months (95% CI: 6.1-6.6 months). Patients who achieved PR at the liver metastasis site after HAIC were more likely to have a longer OS than those who achieved SD or PD. Grade 3 AEs occurred in 12 patients. The most common grade 3 AE was nausea, occurring in 10 (30.0%) patients, followed by abdominal pain in three (9.1%) patients. Only one patient showed grade 3 elevation of alanine aminotransferase (ALT)/aspartate aminotransferase (AST), and one patient suffered from grade 3 embolism syndrome AEs. Grade 4 adverse events, followed by abdominal pain, occurred in one patient.
Conclusion:
Hepatic arterial infusion chemotherapy might be an option as a regional therapy for ESCC patients with LM, as it is acceptable and tolerable.
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