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A pilot study of hepatic arterial infusion of chemotherapy for patients with advanced hepatocellular carcinoma who have failed anti-angiogenic therapy

Authors

  • Yu-Yun Shao,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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    • Both authors contributed equally to this work and share 1st authorship.

  • Po-Chin Liang,

    1. Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan
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    • Both authors contributed equally to this work and share 1st authorship.

  • Yao-Ming Wu,

    1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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  • Chun-Chieh Huang,

    1. Department of Radiology, Far Eastern Memorial Hospital, New Taipei City, Taiwan
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  • Kai-Wen Huang,

    1. Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
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  • Jason C. Cheng,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Chih-Hung Hsu,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Chiun Hsu,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Ann-Lii Cheng,

    1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
    2. Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan
    3. Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
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  • Zhong-Zhe Lin

    Corresponding author
    1. Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan
    2. Department of Oncology, National Taiwan University Hospital Yun-Lin Branch, Yunlin, Taiwan
    • Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan
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Correspondence

Zhong-Zhe Lin, MD, PhD, Department of Oncology, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 10002, Taiwan

Tel: +886 2 23123456 (ext. 71663)

Fax: +886 2 23711174

e-mail: zzlin7460@ntu.edu.tw

Abstract

Background & Aims

For patients with advanced hepatocellular carcinoma (HCC) who have failed first-line anti-angiogenic therapy, there is no salvage treatment. Hepatic arterial infusion of chemotherapy (HAIC) has been reported to achieve substantial treatment responses in HCC patients. We aimed to explore the feasibility of using HAIC as second-line therapy for advanced HCC.

Methods

We retrospectively reviewed all consecutive patients who received HAIC for advanced HCC after failure of first-line anti-angiogenic therapy at a single institute. Patients received HAIC with 60 mg/m2 cisplatin on Day 2, and 500 mg/m2/d dose of 5-fluorouracil on Days 1–3. The treatment was repeated every 21 days and continued until disease progression or the occurrence of intolerable toxicities. Tumour assessment was performed after every 3 cycles of HAIC following RECIST criteria, version 1.0.

Results

A total of 23 patients were included. Eleven (48%) patients had main portal vein thrombosis. Liver reserve was classified as Child-Pugh A in 19 (83%) patients and B in 4 (17%) patients. No complete response was observed, although 6 (26%) patients showed partial responses. The median progression-free survival was 4.4 months, and the median overall survival was 7.5 months. Common toxicities included bone marrow suppression, elevated transaminase levels, neutropenia, nausea and malaise. Only 7 (30%) patients experienced grade 3 or 4 toxicities, and no patients withdrew from the therapy because of intolerable or life-threatening toxicities.

Conclusion

HAIC is a feasible second-line therapy for patients with advanced HCC who have failed anti-angiogenic therapy.

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