REGULAR CONTENT
Final ID
481
Type
Original Scientific Research-Oral or Pos
Authors
R Lokken1, J Hansmann1, A Lipnik1, C Ray1, J Bui1, R Gaba1
Institutions
1University of Illinois Hospital and Health Sciences System, Chicago, IL
Purpose
Idarubicin is more lipophilic and cytotoxic to human hepatocellular carcinoma (HCC) cell lines than doxorubicin and may thus confer a benefit in transarterial chemoembolization (TACE). A 21 patient European trial suggests that idarubicin TACE is safe and effective for HCC. The purpose of this study is to assess toxicity and short-term tumor response following idarubicin TACE in a U.S. population.
Materials & Methods
Records of 20 HCC patients who underwent 28 consecutive idarubicin TACE procedures from 5/2016-9/2016 were retrospectively reviewed. Patients included 19 men and 1 woman (6 White, 6 Hispanic, 5 African American, 3 Asian) with median age of 63 y (range 43-76 y). Cirrhosis was due to HCV in 7, EtOH in 3, NASH in 3, HBV in 2, and multiple factors in 5 patients. At time of TACE, 36% of patients were CP A, 50% CP B, and 14% CP C; 46% were BCLC A, 7% BCLC B, 32% BCLC C, and 14% BCLC D. TACE was performed with an emulsion of 10 mg idarubicin (1mg/mL solution) and 10 mL lipiodol, administered to ≤1 (n=19, 68%) or 2 (n=9, 32%) hepatic segments to angiographic stasis. Median clinical follow-up was 37 d (range 1-99 d). Hepatic toxicity was defined as new/worsening ascites, encephalopathy, or NCI CTCAE grade 3 or 4 elevation of total bilirubin, AST, ALT, creatinine or INR within 30 days. Radiologic response was assessed by mRECIST.
Results
Hepatic toxicity was observed within 30 d in 6 (30%) patients after 7 (25%) procedures. Four (20%) patients developed grade 3 elevations of bilirubin, AST, or ALT; 3 (15%) had worsening ascites. Laboratory toxicity resolved in 3 (75%) patients; worsening ascites was irreversible during follow-up. Postembolization syndrome resulted in new or prolonged hospital admission after 2 (7%) procedures; 1 patient was admitted for spontaneous bacterial peritonitis 6 d after TACE. No patient died or proceeded to liver transplant during follow-up. Contrast-enhanced CT or MRI was performed after 11 procedures by the end of follow-up; complete response was observed in 2 (18%), partial response in 2 (18%), and stable disease in 7 (64%).
Conclusions
Idarubicin-lipiodol TACE of HCC appears to be adequately tolerated and impart disease control in a U.S. population.
Final ID
481
Type
Original Scientific Research-Oral or Pos
Authors
R Lokken1, J Hansmann1, A Lipnik1, C Ray1, J Bui1, R Gaba1
Institutions
1University of Illinois Hospital and Health Sciences System, Chicago, IL
Purpose
Idarubicin is more lipophilic and cytotoxic to human hepatocellular carcinoma (HCC) cell lines than doxorubicin and may thus confer a benefit in transarterial chemoembolization (TACE). A 21 patient European trial suggests that idarubicin TACE is safe and effective for HCC. The purpose of this study is to assess toxicity and short-term tumor response following idarubicin TACE in a U.S. population.
Materials & Methods
Records of 20 HCC patients who underwent 28 consecutive idarubicin TACE procedures from 5/2016-9/2016 were retrospectively reviewed. Patients included 19 men and 1 woman (6 White, 6 Hispanic, 5 African American, 3 Asian) with median age of 63 y (range 43-76 y). Cirrhosis was due to HCV in 7, EtOH in 3, NASH in 3, HBV in 2, and multiple factors in 5 patients. At time of TACE, 36% of patients were CP A, 50% CP B, and 14% CP C; 46% were BCLC A, 7% BCLC B, 32% BCLC C, and 14% BCLC D. TACE was performed with an emulsion of 10 mg idarubicin (1mg/mL solution) and 10 mL lipiodol, administered to ≤1 (n=19, 68%) or 2 (n=9, 32%) hepatic segments to angiographic stasis. Median clinical follow-up was 37 d (range 1-99 d). Hepatic toxicity was defined as new/worsening ascites, encephalopathy, or NCI CTCAE grade 3 or 4 elevation of total bilirubin, AST, ALT, creatinine or INR within 30 days. Radiologic response was assessed by mRECIST.
Results
Hepatic toxicity was observed within 30 d in 6 (30%) patients after 7 (25%) procedures. Four (20%) patients developed grade 3 elevations of bilirubin, AST, or ALT; 3 (15%) had worsening ascites. Laboratory toxicity resolved in 3 (75%) patients; worsening ascites was irreversible during follow-up. Postembolization syndrome resulted in new or prolonged hospital admission after 2 (7%) procedures; 1 patient was admitted for spontaneous bacterial peritonitis 6 d after TACE. No patient died or proceeded to liver transplant during follow-up. Contrast-enhanced CT or MRI was performed after 11 procedures by the end of follow-up; complete response was observed in 2 (18%), partial response in 2 (18%), and stable disease in 7 (64%).
Conclusions
Idarubicin-lipiodol TACE of HCC appears to be adequately tolerated and impart disease control in a U.S. population.