Nonrigid registration for evaluating locoregional therapy of hepatocellular carcinoma

2013 ◽  
Author(s):  
Chunhua Dong ◽  
Toshihito Seki ◽  
Ryosuke Inoguchi ◽  
Chen-Lun Lin ◽  
Xianhua Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Locoregional Therapy ◽  
Nonrigid Registration

Evaluation of Hepatocellular Carcinoma Treatment Response After Locoregional Therapy

2021 ◽  
Vol 29 (3) ◽  
pp. 389-403
Author(s):  
Rony Kampalath ◽  
Karen Tran-Harding ◽  
Richard K.G. Do ◽  
Mishal Mendiratta-Lala ◽  
Vahid Yaghmai
Keyword(s):  
Hepatocellular Carcinoma ◽  
Treatment Response ◽  
Locoregional Therapy

scholarly journals 452 Preliminary analysis of a real-world study (RWS) of camrelizumab treatment in primary liver cancer (PLC)

2021 ◽  
Vol 9 (Suppl 3) ◽  
pp. A479-A480
Author(s):  
Zhendong Chen ◽  
Nianfei Wang ◽  
Dayong Luo ◽  
Bo Jiang ◽  
Mu Yuan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cancer ◽  
Group Performance ◽  
Primary Liver Cancer ◽  
Locoregional Therapy ◽  
Advanced Hepatocellular Carcinoma ◽  
Efficacy And Safety ◽  
Open Label ◽  
Patient Disposition ◽  
Ecog Ps

BackgroundImmune checkpoint inhibitors (ICIs) have revolutionized the landscape of PLC management at all evolutionary stages.1 As an anti-programmed cell death-1 (PD-1) antibody, camrelizumab monotherapy and in combination with apatinib, an anti-angiogenetic tyrosine kinase inhibitor of vascular endothelial growth factor receptor (VEGFR)-2, chemotherapy or locoregional therapy, have demonstrated their efficacy in advanced hepatocellular carcinoma (HCC).2 3 4 5MethodsThis prospective, open-label, multi-center, observational RWS was conducted to evaluate efficacy and safety of camrelizumab in treatment of PLC in clinical practice. Eligible patients were histopathologically or cytologically identified HCC or intrahepatic cholangiocarcinoma, who were going to receive camrelizumab treatment, with age ≥18 ages, Eastern Cooperative Oncology Group performance status (ECOG PS) score of 0–2 and Child-Pugh score ≤ 9. Patients were treated at clinician discretion. Three hundred patients were planned to enroll, including advanced or peri-operative PLC. The primary endpoint was progress-free survival for advanced PLC, whose efficacy was available to analysis. Efficacy was assessed per Response Evaluation Criteria in Solid Tumors version 1.1.ResultsFrom March 29, 2020 to June 10, 2021,a total of 147 eligible patients of advanced PLC were enrolled and included in this interim analysis, with 128 (87.1%) men, 130 (94.9%) ECOG PS of 0–1, 139 (94.6%) HCC, 74 (50.4%) Barcelona Clinic Liver Cancer stage C, 98 (66.7%) Child-Pugh B, and 72 (49.0%) with extrahepatic metastases, shown in table 1. Of the 147 patients, 45 (30.1%) patients were treated with camrelizumab monotherapy, 79 (53.8%) patients with combination with angiogenesis inhibitors, of which 55 (37.4%) in combination with apatinib, 21 (14.3%) patients with camrelizumab and chemotherapy. Patients, who had at least one efficacy assessment, were included in the efficacy analyses. Up to July 19, 2021, with a median follow time of 6.2 months, 132 patients were available for efficacy analyses. Patient disposition was shown in figure 1. Objective response rate (ORR) and disease control rate (DCR) were 10%/30.8%/35.3% and 75.0%/86.5%/70.6% in camrelizumab monotherapy/combined with apatinib/combined with chemotherapy, respectively. (table 2) The most common camrelizumab-treatment related adverse events (AEs) included reactive cutaneous capillary endothelial proliferation (RCCEP) (12, 8.2%), ICI-induced pneumonia (2, 1.4%), enterocolitis (2, 1.4%), and nephritis (1, 0.7%), of which all these AEs recovered. Other AEs included increase of transaminase (5, 3.4%) and hypertension (4, 2.7%). All AEs were 1–2 grade and no treatment-related death occurred.Abstract 452 Table 1Baseline characteristicsAbstract 452 Figure 1Patient dispositionAbstract 452 Table 2Confirmed tumor response assessed by investigators per RECIST v1.1ConclusionsCamrelizumab, combined with anti-angiogenetic agents or chemotherapy, or monotherapy, demonstrated good efficacy and safety in treatment of PLC.Trial RegistrationChiCTR2000034264ReferencesLlovet JM, Kelley RK, Villanueva A, et al. Hepatocellular carcinoma. Nat Rev Dis Primers 2021;7(1):6–28.Qin S, Ren Z, Meng Z, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial. Lancet Oncol 2020;21(4):571–580.Xu J, Shen J, Gu S, et al. Camrelizumab in Combination with Apatinib in Patients with Advanced Hepatocellular Carcinoma (RESCUE): A Nonrandomized, Open-label, Phase II Trial. Clin Cancer Res 2021;27(4):1003–1011.Mei K, Qin S, Chen Z, et al. Camrelizumab in combination with apatinib in second-line or above therapy for advanced primary liver cancer: cohort A report in a multicenter phase Ib/II trial. J Immunother Cancer 2021;9(3).Qin S, Bai Y, Lim HY, et al. Randomized, multicenter, open-label study of oxaliplatin plus fluorouracil/leucovorin versus doxorubicin as palliative chemotherapy in patients with advanced hepatocellular carcinoma from Asia. J Clin Oncol 2013;31(28):3501–3508.Ethics ApprovalThis study was approved by China registered clinical trial ethics review committee with No.ChiECRCT20200042.

scholarly journals Radiological Appearance of Hepatocellular Carcinoma Predicts the Response to Trans-arterial Chemoembolization in Patients Undergoing Liver Transplantation

2019 ◽  
Author(s):  
Wei Zhang ◽  
An-Hui Xu ◽  
Wei Wang ◽  
Yan-Hui Wu ◽  
Qian-Ling Sun ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Tumor Necrosis ◽  
Tumor Response ◽  
Locoregional Therapy ◽  
Arterial Phase ◽  
Radiological Appearance ◽  
Explant Analysis ◽  
Complete Tumor ◽  
Arterial Chemoembolization

Abstract Background: The ultimate goal of locoregional therapy (LRT) to the liver is to induce total tumor necrosis. Trans-arterial chemoembolization (TACE) is the mainstay bridging therapy for patients with hepatocellular carcinoma (HCC) waiting for liver transplantation (LT). However, tumor response rate is variable. The purpose of this study was to correlate HCC radiological appearance with level of tumor necrosis during explant analysis from patients undergoing LT who received pre-LT TACE. Methods: From January 2000 to December 2018, a total of 66 patients with HCC who had been treated prior to LT by means of TACE were analyzed. Diagnosis of HCC was made based on AASLD guidelines and confirmed via histopathology explant analysis. Radiologic tumor response after TACE was based on modified Response Evaluation Criteria in Solid Tumors (mRECIST). Degree of tumor necrosis was determined by histopathology analysis of liver explants. HCC radiological appearances on CT before TACE were assessed and correlated with histological findings after LT. Results: Eighty nine TACE procedures (1.35±0.67; 1-4) were performed, of which 18 were repeated TACE (27.3%) procedures. In 56.1% of the patients, ≥90% (near-complete) tumor necrosis was achieved. Concordance between mRECIST criteria and pathology was observed in 63% of the patients, with an underestimation of tumor response in 18 (27%) patients and an overestimation in 6 (9.1%). Near-complete tumor necrosis upon pathological analysis was associated with tumor hyper-enhancement in the arterial phase (P=0.002), “typical tumor enhancement” (P=0.010) and smooth tumor margins (p=0.011). The multivariate analysis showed that well circumscribed HCCs with smooth margins and arterial hyper-enhancement independently correlated with post-TACE near-complete histological tumor necrosis. Conclusion s : The well circumscribed HCC lesions with arterial hyper-enhancement are more susceptible to TACE than lesions with arterial phase iso or hypo-enhancement and lesions with infiltrative appearance. Pre-TACE CT imaging may ease the selection of an optimal treatment strategy for bridging patients with HCC to liver transplantation.

scholarly journals Clinical efficacy of locoregional therapy prior to living donor liver transplantation for hepatocellular carcinoma based on UCSF criteria

2019 ◽  
Author(s):  
Tsung-Han Wu ◽  
Chih-Hsien Cheng ◽  
Chen-Fang Lee ◽  
Ting-Jung Wu ◽  
Hong-Shiue Chou ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
San Francisco ◽  
Living Donor ◽  
Living Donor Liver Transplantation ◽  
Locoregional Therapy ◽  
Donor Liver ◽  
Donor Liver Transplantation ◽  
Regional Therapy ◽  
Ucsf Criteria

Abstract Background The study analyzed the loco-regional therapy outcomes prior to living donor liver transplantation (LDLT), to provide additional information for decision-making regarding therapeutic strategy for hepatocellular carcinoma (HCC) patients. Methods A total of 308 consecutive patients undergoing LDLTs for HCC between August 2004 and December 2018 were retrospectively analyzed. Patients subjected to loco-regional therapy prior to LT were grouped and the outcomes were compared. Results Overall, HCC recurrence after LDLT were detected in 38 patients (12.3%) during the follow-up period. By the end of the study, 205 patients, 6 of whom with recurrent HCC, were alive. Patients who had radiological imaging beyond the University of California at San Francisco (UCSF) criteria had significant inferior outcomes for both recurrence-free survival (RFS, p = 0.0005) and overall survival (OS, p = 0.0462) despite receiving loco-regional therapy as down-staging intention. Moreover, patients with profound tumor necrosis (TN) had a superior RFS at 3 and 5 years (97.4% and 93.8%, respectively), compared with others. Conclusion LDLT gains a satisfactory result based on the expanded UCSF criteria for HCC. However, the loco-regional therapy prior to LDLT does not seem to provide benefit unless a profound TN is noted.

scholarly journals Selecting the first line treatment in non-metastatic hepatocellular carcinoma - comparing clinical practice guidelines

2020 ◽  
Vol 14 (2) ◽  
Author(s):  
Soumya Jogi ◽  
Radha Varanai ◽  
Sravani S. Bantu ◽  
Ashish Manne
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Systemic Therapy ◽  
Residual Disease ◽  
Disease Process ◽  
Locoregional Therapy ◽  
Line Treatment ◽  
First Line ◽  
Tumor Boards ◽  
First Line Treatment

Primary malignancy of the liver or hepatocellular carcinoma (HCC) is unique in its presentation, disease process, and management. Unlike breast or colon cancer, the staging of HCC depends on performance status and baseline liver function along with pathological characteristics. Apart from traditional options like surgery and systemic therapy, effective management can be achieved in selected cases with liver transplant and locoregional therapy (LRT) like transarterial chemoembolization (TACE), transarterial radioembolization (TARE), and ablation. Liver study societies and cancer groups across the globe proposed guidelines to aid the treating physicians in choosing first-line treatment for liver cancer. It is tough to compare these guidelines as they differ not only in treatment recommendations but also in risk assessment (and staging). The approach to the same patient may be different in the country he or she is managed. In clinical practice, decisions are usually taken on the consensus of multidisciplinary tumor boards and do not necessarily adhere to any guidelines. In the early (and very early) stage HCC, curative options like surgery, transplant, and ablation are recommended. In intermediate stage HCC, LRT (TACE and TARE) is preferred in the first line and systemic therapy for treatment failure or residual disease. Systemic therapy, including the atezolizumab/bevacizumab combination and tyrosine kinase inhibitors (TKI) like sorafenib and lenvatinib, is used for advanced stages. Supportive care is advised for terminal stage HCC.

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment – Part 2

2017 ◽  
Vol 50 (2) ◽  
pp. 115-125 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Diagnostic Algorithm ◽  
Response To Treatment ◽  
Locoregional Therapy ◽  
Liver Imaging ◽  
Imaging Features ◽  
Resonance Imaging ◽  
Magnetic Resonance Imaging Mri

Abstract In the second part of this review, we will describe the ancillary imaging features of hepatocellular carcinoma (HCC) that can be seen on standard magnetic resonance imaging (MRI) protocol, and on novel and emerging protocols such as diffusion weighted imaging and utilization of hepatocyte-specific/hepatobiliary contrast agent. We will also describe the morphologic sub-types of HCC, and give a simplified non-invasive diagnostic algorithm for HCC, followed by a brief description of the liver imaging reporting and data system (LI-RADS), and MRI assessment of tumor response following locoregional therapy.

scholarly journals Outcome of Locoregional Therapy for Hepatocellular Carcinoma (HCC) Before Liver Transplantation

2011 ◽  
Vol 140 (5) ◽  
pp. S-961
Author(s):  
Galal El-Gazzaz ◽  
Rafael A. Ibarra ◽  
Juan Sanabria ◽  
KV Narayanan Menon ◽  
Charles M. Miller ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Locoregional Therapy
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