Gary Garlup Tse MD, Presenter: Nothing to Disclose

Danny Cheng MD, Abstract Co-Author: Nothing to Disclose

Kunal Sidhar MD, Abstract Co-Author: Nothing to Disclose

Kathleen Ai-Lan Khong MD, Abstract Co-Author: Nothing to Disclose

Paul Dong MD, Abstract Co-Author: Nothing to Disclose

Karun V. Sharma MD, PhD, Abstract Co-Author: Nothing to Disclose

To investigate acute changes in proangiogenic biomarkers within the first 24hrs after drug eluting bead chemoembolization (DEB-TACE).

In this prospective pilot study, we recruited 10 patients with unresectable hepatocellular carcinoma eligible for DEB-TACE. Plasma samples were collected before, after, and at 1, 4, and 24 hrs following DEB-TACE. Levels of Serum Amyloid A (SAA), CRP, ICAM-1, VCAM-1 were assayed in triplicates using the Meso Scale Discovery (MSD) Multiplex Panel and analyzed using a SECTOR IMAGER 2400 and MSD DAT software. 

Increase in proangiogenic biomarkers were seen in nearly all patients. A sharp increase in plasma levels of SAA and VCAM-1 were seen in 8/10 patients at 24 hrs after DEB-TACE. Only 2/10 had decreased biomarker levels in both these groups. CRP also increased sharply in 9/10 patients after DEB-TACE and only 1/10 showed a decrease in CRP. ICAM-1 did not demonstrate a consistent or significant change during the first 24 hrs post DEB-TACE; 5/10 patients had minimal increase and 4/10 had minimal decrease.  

Acute changes in plasma levels of proangiogenic biomarkers are detectable following DEB-TACE. The magnitude and direction of change (increase or decrease) suggest a complex angiogenic and inflammatory response following DEB-TACE, which may play a pertinent role in post-embolization neoangiogenesis. Two out of the four factors assayed demonstrated significant increase at 24 hours with a third factor that approached statistical significance. These findings should be confirmed in a larger cohort and in the future, may help to direct periprocedural anti-angiogenic therapy. 

Some patients experience early failure post-TACE. Since embolization is known to promote angiogenesis, upregulation of proangiogenic biomarkers may influence disease response. 

Tse, G, Cheng, D, Sidhar, K, Khong, K, Dong, P, Sharma, K, Pilot Study of Early Changes in Proangiogenic Biomarkers Following DEB-TACE.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002493.html