The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma

Objective: Apatinib is a inhibitor of vascular endothelial growth factor receptor-2. To explore the efficacy and prognostic factors of transarterial chemoembolization (TACE) combined with apatinib in the treatment of Barcelona Clinic Liver Cancer stage C (BCLC C) hepatocellular carcinoma (HCC).Metho...

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Autores principales: Shun Liu, Kai-Cai Liu, Wei-Fu Lv, Dong Lu, Xian-Hai Zhu, Bo Jiang, Yu-Lin Tan, Guo-Xiang Wang
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Publicado: Frontiers Media S.A. 2021
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spelling oai:doaj.org-article:6bb532298dbb4bf9b78cb6cca1a694df2021-12-03T05:12:15ZThe Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma2296-858X10.3389/fmed.2021.774345https://doaj.org/article/6bb532298dbb4bf9b78cb6cca1a694df2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.774345/fullhttps://doaj.org/toc/2296-858XObjective: Apatinib is a inhibitor of vascular endothelial growth factor receptor-2. To explore the efficacy and prognostic factors of transarterial chemoembolization (TACE) combined with apatinib in the treatment of Barcelona Clinic Liver Cancer stage C (BCLC C) hepatocellular carcinoma (HCC).Methods: Clinical data of 146 HCC patients with BCLC stage C admitted to our hospital were collected and analyzed retrospectively, of which 76 cases were treated with TACE combined with apatinib (TACE-apatinib) and 70 with TACE alone. The tumor response, survival time, and adverse events were compared between the two groups, and the factors affecting the prognosis were analyzed.Results: The objective response rate (ORR) and disease control rate (DCR) in the TACE-apatinib group were higher than in the TACE-alone group (ORR: 42.10 vs. 25.71%, P = 0.03; DCR: 84.21 vs. 55.71%, P = 0.001). The median time to progression (TTP) and overall survival (OS) in the TACE-apatinib group were longer than in the TACE-alone group (TTP: 5.5 vs. 3.7 months, P = 0.02; OS: 10.0 vs. 6.2 months, P = 0.01). Univariate and multivariate Cox regression analysis showed that tumor size, Child-Pugh class, and the presence of the portal vein tumor thrombus affect the prognosis of patients. Subgroup analysis revealed that TACE-apatinib therapy resulted in a higher OS in patients with tumor size <10 cm, without portal vein tumor thrombus, and with Child-Pugh class A (P < 0.05). The likelihood of adverse events (hand-foot syndrome, hypertension, oral ulcer) was significantly higher in the increased in the TACE-apatinib group than in the TACE alone group (P < 0.05).Conclusion: TACE-apatinib is an effective and safe method for the treatment of BCLC stage C HCC. Tumor size, Child-Pugh class, and portal vein tumor thrombus affect survival time in HCC patients with BCLC stage C.Shun LiuShun LiuKai-Cai LiuWei-Fu LvWei-Fu LvDong LuXian-Hai ZhuBo JiangYu-Lin TanGuo-Xiang WangFrontiers Media S.A.articlehepatocellular carcinomaTACEapatinibefficacyprognostic factorsMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution DOAJ
collection DOAJ
language EN
topic hepatocellular carcinoma
TACE
apatinib
efficacy
prognostic factors
Medicine (General)
R5-920
spellingShingle hepatocellular carcinoma
TACE
apatinib
efficacy
prognostic factors
Medicine (General)
R5-920
Shun Liu
Shun Liu
Kai-Cai Liu
Wei-Fu Lv
Wei-Fu Lv
Dong Lu
Xian-Hai Zhu
Bo Jiang
Yu-Lin Tan
Guo-Xiang Wang
The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
description Objective: Apatinib is a inhibitor of vascular endothelial growth factor receptor-2. To explore the efficacy and prognostic factors of transarterial chemoembolization (TACE) combined with apatinib in the treatment of Barcelona Clinic Liver Cancer stage C (BCLC C) hepatocellular carcinoma (HCC).Methods: Clinical data of 146 HCC patients with BCLC stage C admitted to our hospital were collected and analyzed retrospectively, of which 76 cases were treated with TACE combined with apatinib (TACE-apatinib) and 70 with TACE alone. The tumor response, survival time, and adverse events were compared between the two groups, and the factors affecting the prognosis were analyzed.Results: The objective response rate (ORR) and disease control rate (DCR) in the TACE-apatinib group were higher than in the TACE-alone group (ORR: 42.10 vs. 25.71%, P = 0.03; DCR: 84.21 vs. 55.71%, P = 0.001). The median time to progression (TTP) and overall survival (OS) in the TACE-apatinib group were longer than in the TACE-alone group (TTP: 5.5 vs. 3.7 months, P = 0.02; OS: 10.0 vs. 6.2 months, P = 0.01). Univariate and multivariate Cox regression analysis showed that tumor size, Child-Pugh class, and the presence of the portal vein tumor thrombus affect the prognosis of patients. Subgroup analysis revealed that TACE-apatinib therapy resulted in a higher OS in patients with tumor size <10 cm, without portal vein tumor thrombus, and with Child-Pugh class A (P < 0.05). The likelihood of adverse events (hand-foot syndrome, hypertension, oral ulcer) was significantly higher in the increased in the TACE-apatinib group than in the TACE alone group (P < 0.05).Conclusion: TACE-apatinib is an effective and safe method for the treatment of BCLC stage C HCC. Tumor size, Child-Pugh class, and portal vein tumor thrombus affect survival time in HCC patients with BCLC stage C.
format article
author Shun Liu
Shun Liu
Kai-Cai Liu
Wei-Fu Lv
Wei-Fu Lv
Dong Lu
Xian-Hai Zhu
Bo Jiang
Yu-Lin Tan
Guo-Xiang Wang
author_facet Shun Liu
Shun Liu
Kai-Cai Liu
Wei-Fu Lv
Wei-Fu Lv
Dong Lu
Xian-Hai Zhu
Bo Jiang
Yu-Lin Tan
Guo-Xiang Wang
author_sort Shun Liu
title The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
title_short The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
title_full The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
title_fullStr The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
title_full_unstemmed The Efficacy and Prognostic Factors of the Combination of TACE and Apatinib for the Treatment of BCLC Stage C Hepatocellular Carcinoma
title_sort efficacy and prognostic factors of the combination of tace and apatinib for the treatment of bclc stage c hepatocellular carcinoma
publisher Frontiers Media S.A.
publishDate 2021
url https://doaj.org/article/6bb532298dbb4bf9b78cb6cca1a694df
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