AI Article Synopsis

  • A phase III trial involving 12 centers in China compared the effectiveness of drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with apatinib against DEB-TACE alone for patients with unresectable hepatocellular carcinoma (uHCC).
  • The results showed that the combination treatment led to significantly better progression-free survival (7.1 months vs. 5.2 months) and overall survival (23.3 months vs. 18.9 months), along with higher response rates and disease control.
  • Most treatment-related adverse events were mild, although there were some increased risks of side effects such as hypertension and fatigue associated with the combination therapy, which still had an overall favorable safety profile

Article Abstract

This randomized, prospective, multicenter (12 centers in China) phase III trial (Chinese Clinical Trial Registry #ChiCTR2000041170) compared drug-eluting bead transarterial chemoembolization (DEB-TACE) combined with apatinib and DEB-TACE monotherapy for patients with unresectable hepatocellular carcinoma (uHCC). Progression-free survival (PFS) was the primary endpoint. Overall survival (OS), mRECIST-based objective response rates (ORR) and disease control rates (DCR), and treatment-related adverse events (TRAEs) were secondary endpoints. Totally 243 cases were randomized, with 122 and 121 in the DEB-TACE + apatinib and DEB-TACE groups, respectively. Cases administered DEB-TACE + apatinib displayed markedly improved median PFS (7.1 months [95%CI 6.6-8.3] vs. 5.2 months [95%CI 5.0-5.9]) and OS (23.3 months [95%CI 20.7-29.6] vs. 18.9 months [95%CI 17.9-20.1] compared with those treated with DEB-TACE (both p < 0.001). Additionally, patients administered DEB-TACE + apatinib had elevated ORR (56.6% vs. 38.8%) and DCR (89.3% vs. 80.2%) versus the DEB-TACE group (both p < 0.001). Majority of TRAEs were mild and manageable. Regarding DEB-TACE-related TRAEs, the rates of hepatic artery thinning and spasms were elevated during the second DEB-TACE in cases administered DEB-TACE + apatinib vs. DEB-TACE. The commonest apatinib-related TRAEs in the DEB-TACE + apatinib group included hypertension, hand-foot syndrome, fatigue, and diarrhea. In conclusion, DEB-TACE plus apatinib demonstrates superior PFS versus DEB-TACE monotherapy in uHCC cases, maintaining a favorable safety profile with similar occurrences of AEs.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11557926PMC
http://dx.doi.org/10.1038/s41392-024-02012-xDOI Listing

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