- Intermediate-stage or outside the Milan criteria hepatocellular carcinoma (HCC) patients with no objective response (OR) after 2 consecutive transarterial chemoembolization (TACE) sessions rarely benefited from a third.
Why this matters
- No evidence-based criteria are available for when to stop TACE treatments, although consensus-based guidelines suggest switching to systemic treatment after 2 attempts that fail to achieve an OR.
- Retrospective analysis at a single center in the Republic of Korea (n=200; 91.0% male).
- Funding: Bayer.
- The mean size of the largest tumor was 6.8 cm.
- 40.5% of patients had 4 or more tumors.
- The overall response rate after 2 TACE sessions was 36.9%.
- After 1 TACE session, 24.0% achieved a complete response, 43.5% a partial response, and 29.5% stable disease; 3.0% experienced progressive disease.
- 22.5% of patients had no OR after 2 successive TACE sessions.
- In this group, 28 patients went on to a third TACE session, with an OR rate of 10.7%.
- Factors associated with failure to achieve OR after 2 TACE sessions included tumor size >5 cm (adjusted odds ratio [aOR], 3.74; P=.003) and alpha-fetoprotein >200 ng/mL (aOR, 3.11; P=.005).
- Retrospective, single-center study; Asian population.