Transarterial Embolization Alone Versus Drug-Eluting Microspheres Chemoembolization for Hepatocellular...

Area of Science:

• Interventional Radiology
• Hepatobiliary Oncology
• Clinical Trials

Background:

• Hepatocellular carcinoma (HCC) is a primary liver malignancy with limited treatment options for unresectable cases.
• Transarterial therapies are standard treatments for intermediate-stage HCC.
• Comparing established techniques with newer drug-eluting methods is crucial for optimizing patient care.

Purpose of the Study:

• To conduct a non-inferiority randomized clinical trial comparing transarterial embolization (TAE) and drug-eluting microspheres transarterial chemoembolization (DEM-TACE).
• To evaluate the efficacy and safety of TAE versus DEM-TACE in patients with unresectable HCC.
• To determine if DEM-TACE is non-inferior to TAE in terms of time to progression.

Main Methods:

• A randomized clinical trial involving 111 patients with unresectable HCC.
• Patients were assigned to either TAE or DEM-TACE groups.
• Primary endpoint: time to progression (TTP). Secondary endpoints: overall survival, hospitalization duration, tumor response, and severe adverse events (SAE).

Main Results:

• Median TTP was similar between TAE (7.56 months) and DEM-TACE (7.98 months).
• Equivalence in TTP was confirmed by TOST analysis (p < 0.001).
• No statistically significant differences were observed in overall survival, tumor response rates, SAEs, or hospitalization duration between the two groups.

Conclusions:

• Transarterial embolization (TAE) and drug-eluting microspheres transarterial chemoembolization (DEM-TACE) demonstrate comparable efficacy and safety profiles.
• Both treatments are effective options for managing early and intermediate-stage unresectable HCC.
• The findings support the use of both TAE and DEM-TACE in clinical practice for HCC treatment.