Keyan B. Marashi MD, Presenter: Nothing to Disclose

Marco A. Cura MD, Abstract Co-Author: Nothing to Disclose

Justin Decker Sacks MD, Abstract Co-Author: Nothing to Disclose

James Dale Meler MD, Abstract Co-Author: Nothing to Disclose

To evaluate patient tolerability and efficacy of transarterial chemoembolization (TACE) with 70-150 µm doxorubicin-loaded drug-eluting beads (DEB) in patients with hepatocellular carcinoma (HCC).

48 consecutive patients (36 male, mean age 62.3yo, r31-81y) with unresectable HCC who underwent 54 TACE sessions with 70-150 µm doxorubicin-loaded DEB for unresectable HCC were retrospectively reviewed. 31 of 48 patients (65%) were classified as Barcelona Clinic Liver Cancer stage A, 15 (31%) were stage B, and 2 (4%) were stage C. Tumor size ranged from 1.3 cm to 8.5 cm (24 focal, 24 multifocal). Doxorubicin dose ranged from 7.5mg to 150mg. At the time of submission, follow-up imaging was available for 32 patients and was evaluated using mRECIST.

42 patients underwent a single session of TACE and 6 patients underwent two sessions. One procedural complication was encountered: a dissection of the common hepatic artery. 49 sessions resulted in discharge within 24 hours of TACE. 5 sessions required admission greater than 24 hours: 1 for nausea, fever, and emesis, 3 for abdominal pain, and 1 for unrelated medical care. Of the 32 patients for which follow-up imaging was available, 7 demonstrated complete response (21.9%), 10 demonstrated partial response (31.2%), 12 demonstrated stable disease (37.5%), and 3 demonstrated progressive disease (9.4%). Mean follow-up time since DEB-TACE was 122 days (r4-940 days). 4 patients were bridged to transplant. During follow-up, one patient death was recorded secondary to complications of liver transplant. Kaplan-Meier survival at 3, 6, and 12 months was 100%, 95%, and 95% respectively.

TACE with 70-150 µm doxorubicin-loaded DEB appears safe and effective for treatment of patients with unresectable HCC. In our population, the procedure was tolerated well, with the majority of patients showing favorable to stable tumor response.

In vivo studies show that smaller 70-150 µm DEB penetrate further into tissue resulting in greater and more uniform drug coverage, but clinical studies to assess tolerability and efficacy are lacking.

Marashi, K, Cura, M, Sacks, J, Meler, J, Tolerability and Efficacy of Transarterial Chemoembolization of Hepatocellular Carcinoma with 70-150 µm Doxorubicin-Loaded-Drug-Eluting-Beads.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002635.html