Challenges in combining antiangiogenic therapy with transarterial chemoembolization for hepatocellular carcinoma Journal Article


Authors: Haydar, A. A.; Mukherji, D.; Faraj, W.; Khalifeh, M.; Taslakian, B.; Yehia, Z. A.; Temraz, S.; Brown, K. T.; Abou-Alfa, G. K.; Shamseddine, A.
Article Title: Challenges in combining antiangiogenic therapy with transarterial chemoembolization for hepatocellular carcinoma
Abstract: Background: The combination of systemic antiangiogenic therapy and transarterial chemoembolization (TACE) for the treatment of unresectable hepatocellular carcinoma (HCC) is the subject of several ongoing clinical trials. We present a series of patients treated with sorafenib and TACE at our institution, highlighting the technical challenges of combining these two modalities of treatment. Methods: We retrospectively identified patients with HCC treated with TACE and sorafenib at our institution. Results: Five patients were treated with the combination of TACE and sorafenib given off-protocol based on preliminary reports in the literature. The first four patients started sorafenib 7 days prior to TACE resulting in intratumoral vascular pruning and poor visualization of lesions on angiography. This was managed by either superselective angiography or lobar TACE. The fifth patient stopped sorafenib 7 days prior to TACE with full visualization of multiple hypervascular lesions on angiography prior to embolization. Conclusions: Our observations suggest that the biologically preferable strategy of continuous antiangiogenic therapy should be weighed against the possibility of suboptimal TACE due to poor visualization of lesions on angiography and safety.
Journal Title: Gastrointestinal Cancer Research
Volume: 7
Issue: 3-4
ISSN: 1934-7820
Publisher: International Society of Gastrointestinal Oncology  
Date Published: 2014-05-01
Start Page: 98
End Page: 102
Language: English
PROVIDER: scopus
PMCID: PMC4171975
PUBMED: 25276263
DOI/URL:
Notes: Export Date: 3 November 2014 -- Source: Scopus
Citation Impact
MSK Authors
  1. Ghassan Abou-Alfa
    568 Abou-Alfa
  2. Karen T Brown
    178 Brown