Drug & Device Development

Doxorubicin-eluting beads improve HCC outcomes

Last Updated: 2012-08-01 18:10:04 -0400 (Reuters Health)

By Will Boggs, MD

NEW YORK (Reuters Health) - Unresectable hepatocellular carcinoma (HCC) responded more often to transarterial chemoembolization (TACE) when doxorubicin-eluting beads were used, in a recent retrospective study.

The product, called DC Beads by manufacturer Biocompatibles International Ltd, is available in Europe, Canada, Taiwan and elsewhere, but not in the U.S.

DC bead TACE may be a promising treatment modality for HCC because it diminishes the amount of chemotherapeutic agent that reaches the systemic circulation and reduces drug-related side effects, Dr. Seung Kew Yoon from The Catholic University of Korea in Seoul, senior author of the new study, told Reuters Health in an email.

In light of Western experiences suggesting superiority of DC beads over conventional TACE, Dr. Yoon and colleagues reviewed the efficacy, safety, and overall survival benefit of DC beds vs conventional TACE in 129 Korean patients with HCC.

As reported July 20 online in the Journal of Hepatology, the complete response rate was significantly higher with vs without DC beads (55% vs 23.1%).

Including partial responses, the DC beads group had a significantly higher response than the conventional TACE group (P<0.001).

The significantly better treatment response and objective response rates were restricted to patients with intermediate-stage HCC, however. Response rates did not differ significantly between DC beads and conventional TACE among patients with early-stage disease.

The disease progression rate was lower with DC beads than with conventional TACE (50% vs 70%), and median time to progression was longer with DC beads (11.7 vs 7.6 months). Again, these benefits were confined to patients with intermediate-stage HCC.

Primarily as a result of lower tumor progression, overall survival was greater with DC beads than with conventional TACE (mean, 32.2 vs 24.7 months).

Besides DC bead treatment, significant independent predictors for tumor progression and overall survival included higher alpha-fetoprotein level and higher Barcelona Clinic for Liver Cancer (BCLC) stage.

Adverse events occurred with similar frequency in the two treatment groups.

The researchers note the retrospective nature and short follow-up as shortcomings of the study, suggesting the need for a further prospective study with long-term follow-up.

"DC bead TACE has an advantage in tumor response or survival and thus this approach should be firstly considered for the treatment of HCC with intermediate or more advanced stage," Dr. Yoon concluded.

But, Dr. Yoon added, "Because TACE with DC beads is more expensive compared to conventional TACE, it may be used optionally according to patient's economic status."

SOURCE: http://bit.ly/McQwrR

J Hepatol 2012.