Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC)
Journal
Liver International
Journal Volume
33
Journal Issue
3
Pages
327-337
Date Issued
2013
Author(s)
Park J.-W.
Amarapurkar D.
Chao Y.
Geschwind J.-F.H.
Goh K.L.
Han K.-H.
Kudo M.
Lee H.C.
Lee R.-C.
Lesmana L.A.
Lim H.Y.
Paik S.W.
Poon R.T.
Tan C.-K.
Tanwandee T.
Teng G.
Abstract
Hepatocellular carcinoma (HCC) presents with a high burden of disease in East Asian countries. Intermediate-stage HCC as defined by the Barcelona Clinic Liver Cancer (BCLC) staging system poses a clinical challenge as it includes a heterogeneous population of patients that can vary widely in terms of tumour burden, liver function and disease aetiology. Intermediate HCC patients often have unsatisfactory clinical outcomes with repeated transarterial chemoembolization (TACE, due to non-response of the target tumour or the development of further metastasis indicating progressive disease. In September 2011, an Expert Panel Opinion on Interventions in Hepatocellular Carcinoma (EPOIHCC) was convened in HK in an attempt to provide a consensus on the practice of TACE. To that end, current clinical practice throughout Asia was reviewed in detail including safety and efficacy data on TACE alone as well as in combination with targeted systemic therapies. This review summarises the evidence discussed at the meeting and provides expert recommendation regarding the available therapeutic options for unresectable intermediate stage HCC. A key consensus of the Expert Panel was that in order to improve patient outcomes and long-term survival, the possibility of using TACE in combination with targeted agents given systemically should be explored. While the currently available clinical data is promising, the expected completion of several pivotal phase II and III RCTs will provide further evidence in support of the rationale for combination therapy regimens. ? 2013 John Wiley & Sons A/S.
SDGs
Other Subjects
cisplatin; doxorubicin; epirubicin; gelatin sponge; iodinated poppyseed oil; microsphere; mitomycin; oxaliplatin; placebo; sorafenib; virus DNA; yttrium 90; article; Asia; cancer combination chemotherapy; cancer growth; cancer prognosis; cancer radiotherapy; cancer size; cancer staging; cancer surgery; cancer survival; chemoembolization; clinical practice; consensus; consensus development; disease free survival; drug efficacy; drug safety; external beam radiotherapy; functional status; hepatitis B; hepatitis C; human; liver abscess; liver cell carcinoma; liver function; liver metastasis; long term survival; meta analysis; molecularly targeted therapy; multimodality cancer therapy; outcome assessment; overall survival; patient selection; phase 2 clinical trial (topic); phase 3 clinical trial (topic); progression free survival; radiofrequency ablation; randomized controlled trial (topic); repeat procedure; survival rate; systemic therapy; treatment duration; treatment response; tumor growth
Publisher
Blackwell Publishing Ltd
Type
journal article