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Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Hepatocellular Carcinoma | Research

A retrospective pilot study of transarterial chemoembolisation using camrelizumab-eluting Callisphere beads for unresectable hepatocellular carcinoma

Authors: Xiaonan Shi, Yang Wang, Jianzhuang Ren, Xinwei Han, Yonghua Bi

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

Our objective was to assess the efficacy and safety of initial hepatic arterial infusion of chemotherapy combined with transarterial chemoembolisation using camrelizumab-eluting Callisphere beads (camrelizumab-DEB-TACE) for treating unresectable hepatocellular carcinoma (HCC).

Methods

Enrolment included patients with unresectable HCC who underwent camrelizumab-DEB-TACE treatment from September 2021 to February 2023. The assessment included the examination of tumour response, overall survival (OS), progression-free survival (PFS), and the monitoring of adverse events (AEs).

Results

Twenty-one patients were included in the study. The objective response rates (ORR) and disease control rates (DCR) were 55.0% and 90.0% at 1 month and 57.9% and 78.9% at 3 months, respectively. The median PFS and OS were 7.4 and 15.5 months months, respectively. Among the 21 patients, 4 underwent more than 2 procedures of camrelizumab-DEB-TACE, with a mean of 1.9 ± 1.1 procedures (range: 1–4) per patient. No severe complications or treatment-related mortalities were observed. In addition, no patient developed severe AEs related to camrelizumab, such as reactive cutaneous capillary endothelial proliferation, immune-related pneumonia, or immune-related myocarditis. Nineteen patients experienced at least one type of AEs related to DEB-TACE, with abdominal pain (n = 16, 76.2%) being the most prevalent AE.

Conclusion

Camrelizumab-DEB-TACE demonstrated effectiveness and safety as a treatment for unresectable HCC, with no occurrence of severe camrelizumab-related AEs.
Literature
1.
go back to reference Liver. EA. .f.t.S.o.t., EASL Clinical Practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236.CrossRef Liver. EA. .f.t.S.o.t., EASL Clinical Practice guidelines: management of hepatocellular carcinoma. J Hepatol. 2018;69(1):182–236.CrossRef
2.
go back to reference Kim JW, Kim JH, Sung KB, Ko HK, Shin JH, Kim PN, Choi HK, Ko GY, Yoon HK, Chun SY, et al. Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller. Am J Gastroenterol. 2014;109(8):1234–40.CrossRefPubMed Kim JW, Kim JH, Sung KB, Ko HK, Shin JH, Kim PN, Choi HK, Ko GY, Yoon HK, Chun SY, et al. Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller. Am J Gastroenterol. 2014;109(8):1234–40.CrossRefPubMed
3.
go back to reference Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37(2):429–42.CrossRefPubMed Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37(2):429–42.CrossRefPubMed
4.
go back to reference Bi Y, Wang Y, Zhang W, Lu H, Ren J, Han X. Preliminary outcomes of DEB-TACE loaded with raltitrexed in the treatment of unresectable or recurrent hepatocellular carcinoma. Cancer Imaging. 2023;23(1):19.CrossRefPubMedPubMedCentral Bi Y, Wang Y, Zhang W, Lu H, Ren J, Han X. Preliminary outcomes of DEB-TACE loaded with raltitrexed in the treatment of unresectable or recurrent hepatocellular carcinoma. Cancer Imaging. 2023;23(1):19.CrossRefPubMedPubMedCentral
5.
go back to reference Sheta E, El-Kalla F, El-Gharib M, Kobtan A, Elhendawy M, Abd-Elsalam S, Mansour L, Amer I. Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study. Eur J Gastroenterol Hepatol. 2016;28(10):1198–203.CrossRefPubMed Sheta E, El-Kalla F, El-Gharib M, Kobtan A, Elhendawy M, Abd-Elsalam S, Mansour L, Amer I. Comparison of single-session transarterial chemoembolization combined with microwave ablation or radiofrequency ablation in the treatment of hepatocellular carcinoma: a randomized-controlled study. Eur J Gastroenterol Hepatol. 2016;28(10):1198–203.CrossRefPubMed
6.
go back to reference Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T, Matsuyama Y, Nakanuma Y, Kojiro M, Makuuchi M, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461–9.CrossRefPubMed Takayasu K, Arii S, Ikai I, Omata M, Okita K, Ichida T, Matsuyama Y, Nakanuma Y, Kojiro M, Makuuchi M, et al. Prospective cohort study of transarterial chemoembolization for unresectable hepatocellular carcinoma in 8510 patients. Gastroenterology. 2006;131(2):461–9.CrossRefPubMed
7.
go back to reference Chao J, Zhu Q, Chen D, An X, Liu A, Zhou F, Yuan L, Wang Z, Sun H. Case Report: Transarterial Chemoembolization in Combination with Tislelizumab Downstages Unresectable Hepatocellular Carcinoma followed by Radical Salvage Resection. Front Oncol. 2021;11:667555.CrossRefPubMedPubMedCentral Chao J, Zhu Q, Chen D, An X, Liu A, Zhou F, Yuan L, Wang Z, Sun H. Case Report: Transarterial Chemoembolization in Combination with Tislelizumab Downstages Unresectable Hepatocellular Carcinoma followed by Radical Salvage Resection. Front Oncol. 2021;11:667555.CrossRefPubMedPubMedCentral
8.
go back to reference El-Khoueiry AB, Sangro B, Yau T, Crocenzi TS, Kudo M, Hsu C, Kim TY, Choo SP, Trojan J, Welling THR, et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet. 2017;389(10088):2492–502.CrossRefPubMedPubMedCentral El-Khoueiry AB, Sangro B, Yau T, Crocenzi TS, Kudo M, Hsu C, Kim TY, Choo SP, Trojan J, Welling THR, et al. Nivolumab in patients with advanced hepatocellular carcinoma (CheckMate 040): an open-label, non-comparative, phase 1/2 dose escalation and expansion trial. Lancet. 2017;389(10088):2492–502.CrossRefPubMedPubMedCentral
9.
go back to reference Zhan C, Ruohoniemi D, Shanbhogue KP, Wei J, Welling TH, Gu P, Park JS, Dagher NN, Taslakian B, Hickey RM. Safety of combined Yttrium-90 radioembolization and Immune checkpoint inhibitor immunotherapy for Hepatocellular Carcinoma. J Vasc Interv Radiol. 2020;31(1):25–34.CrossRefPubMed Zhan C, Ruohoniemi D, Shanbhogue KP, Wei J, Welling TH, Gu P, Park JS, Dagher NN, Taslakian B, Hickey RM. Safety of combined Yttrium-90 radioembolization and Immune checkpoint inhibitor immunotherapy for Hepatocellular Carcinoma. J Vasc Interv Radiol. 2020;31(1):25–34.CrossRefPubMed
10.
go back to reference Marinelli B, Cedillo M, Pasik SD, Charles D, Murthy S, Patel RS, Fischman A, Ranade M, Bishay V, Nowakowski S, et al. Safety and Efficacy of Locoregional Treatment during Immunotherapy with Nivolumab for Hepatocellular Carcinoma: a retrospective study of 41 interventions in 29 patients. J Vasc Interv Radiol. 2020;31(11):1729–38. e1.CrossRefPubMed Marinelli B, Cedillo M, Pasik SD, Charles D, Murthy S, Patel RS, Fischman A, Ranade M, Bishay V, Nowakowski S, et al. Safety and Efficacy of Locoregional Treatment during Immunotherapy with Nivolumab for Hepatocellular Carcinoma: a retrospective study of 41 interventions in 29 patients. J Vasc Interv Radiol. 2020;31(11):1729–38. e1.CrossRefPubMed
11.
go back to reference Qin S, Ren Z, Meng Z, Chen Z, Chai X, Xiong J, Bai Y, Yang L, Zhu H, Fang W, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial. Lancet Oncol. 2020;21(4):571–80.CrossRefPubMed Qin S, Ren Z, Meng Z, Chen Z, Chai X, Xiong J, Bai Y, Yang L, Zhu H, Fang W, et al. Camrelizumab in patients with previously treated advanced hepatocellular carcinoma: a multicentre, open-label, parallel-group, randomised, phase 2 trial. Lancet Oncol. 2020;21(4):571–80.CrossRefPubMed
12.
go back to reference Ren Y, Liu Z, Makamure J, Kan X, Song S, Liu Y, Qian K, Zheng C, Liang B. Addition of Camrelizumab to Transarterial Chemoembolization in Hepatocellular Carcinoma with untreatable progression. Technol Cancer Res Treat. 2022;21:15330338221131385.CrossRefPubMedPubMedCentral Ren Y, Liu Z, Makamure J, Kan X, Song S, Liu Y, Qian K, Zheng C, Liang B. Addition of Camrelizumab to Transarterial Chemoembolization in Hepatocellular Carcinoma with untreatable progression. Technol Cancer Res Treat. 2022;21:15330338221131385.CrossRefPubMedPubMedCentral
13.
go back to reference Bi Y, Shi X, Ren J, Yi M, Han X, Song M. Clinical outcomes of doxorubicin-eluting CalliSpheres(R) beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma. BMC Gastroenterol. 2021;21(1):231.CrossRefPubMedPubMedCentral Bi Y, Shi X, Ren J, Yi M, Han X, Song M. Clinical outcomes of doxorubicin-eluting CalliSpheres(R) beads-transarterial chemoembolization for unresectable or recurrent esophageal carcinoma. BMC Gastroenterol. 2021;21(1):231.CrossRefPubMedPubMedCentral
14.
go back to reference Bi Y, Ren K, Ren J, Ma J, Han X. Oxaliplatin Eluting CalliSpheres microspheres for the treatment of unresectable or recurrent Hepatocellular Carcinoma. Frontiers in Pharmacology; 2022. Bi Y, Ren K, Ren J, Ma J, Han X. Oxaliplatin Eluting CalliSpheres microspheres for the treatment of unresectable or recurrent Hepatocellular Carcinoma. Frontiers in Pharmacology; 2022.
15.
go back to reference Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52–60.CrossRefPubMed Lencioni R, Llovet JM. Modified RECIST (mRECIST) assessment for hepatocellular carcinoma. Semin Liver Dis. 2010;30(1):52–60.CrossRefPubMed
16.
go back to reference Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment Semin Radiat Oncol, 2003; 13(3): 176 – 81. Trotti A, Colevas AD, Setser A, Rusch V, Jaques D, Budach V, Langer C, Murphy B, Cumberlin R, Coleman CN et al. CTCAE v3.0: development of a comprehensive grading system for the adverse effects of cancer treatment Semin Radiat Oncol, 2003; 13(3): 176 – 81.
17.
go back to reference Abd E, Aziz MA, Facciorusso A, Nayfeh T, Saadi S, Elnaggar M, Cotsoglou C, Sacco R. Immune Checkpoint inhibitors for Unresectable Hepatocellular Carcinoma. Vaccines (Basel), 2020; 8(4). Abd E, Aziz MA, Facciorusso A, Nayfeh T, Saadi S, Elnaggar M, Cotsoglou C, Sacco R. Immune Checkpoint inhibitors for Unresectable Hepatocellular Carcinoma. Vaccines (Basel), 2020; 8(4).
18.
go back to reference Takaki H, Imai N, Contessa TT, Srimathveeravalli G, Covey AM, Getrajdman GI, Brown KT, Solomon SB, Erinjeri JP. Peripheral blood Regulatory T-Cell and Type 1 helper T-Cell Population decrease after hepatic artery embolization. J Vasc Interv Radiol. 2016;27(10):1561–8.CrossRefPubMedPubMedCentral Takaki H, Imai N, Contessa TT, Srimathveeravalli G, Covey AM, Getrajdman GI, Brown KT, Solomon SB, Erinjeri JP. Peripheral blood Regulatory T-Cell and Type 1 helper T-Cell Population decrease after hepatic artery embolization. J Vasc Interv Radiol. 2016;27(10):1561–8.CrossRefPubMedPubMedCentral
19.
go back to reference Xie DY, Ren ZG, Zhou J, Fan J, Gao Q. 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr. 2020;9(4):452–63.CrossRefPubMedPubMedCentral Xie DY, Ren ZG, Zhou J, Fan J, Gao Q. 2019 Chinese clinical guidelines for the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr. 2020;9(4):452–63.CrossRefPubMedPubMedCentral
20.
go back to reference Xie DY, Zhu K, Ren ZG, Zhou J, Fan J, Gao Q. A review of 2022 Chinese clinical guidelines on the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr. 2023;12(2):216–28.CrossRefPubMedPubMedCentral Xie DY, Zhu K, Ren ZG, Zhou J, Fan J, Gao Q. A review of 2022 Chinese clinical guidelines on the management of hepatocellular carcinoma: updates and insights. Hepatobiliary Surg Nutr. 2023;12(2):216–28.CrossRefPubMedPubMedCentral
21.
go back to reference Bi Y, Jiao D, Ren J, Han X. Clinical outcomes of drug-eluting bead Transarterial Chemoembolization loaded with raltitrexed for theTreatment of unresectable or recurrent Hepatocellular Carcinoma. Can J Gastroenterol Hepatol; 2022. Bi Y, Jiao D, Ren J, Han X. Clinical outcomes of drug-eluting bead Transarterial Chemoembolization loaded with raltitrexed for theTreatment of unresectable or recurrent Hepatocellular Carcinoma. Can J Gastroenterol Hepatol; 2022.
22.
go back to reference Hwang SJ, Carlos G, Wakade D, Byth K, Kong BY, Chou S, Carlino MS, Kefford R, Fernandez-Penas P. Cutaneous adverse events (AEs) of anti-programmed cell death (PD)-1 therapy in patients with metastatic Melanoma: a single-institution cohort. J Am Acad Dermatol. 2016;74(3):455–61. e1.CrossRefPubMed Hwang SJ, Carlos G, Wakade D, Byth K, Kong BY, Chou S, Carlino MS, Kefford R, Fernandez-Penas P. Cutaneous adverse events (AEs) of anti-programmed cell death (PD)-1 therapy in patients with metastatic Melanoma: a single-institution cohort. J Am Acad Dermatol. 2016;74(3):455–61. e1.CrossRefPubMed
23.
go back to reference Huang J, Xu B, Mo H, Zhang W, Chen X, Wu D, Qu D, Wang X, Lan B, Yang B, et al. Safety, Activity, and biomarkers of SHR-1210, an Anti-PD-1 antibody, for patients with Advanced Esophageal Carcinoma. Clin Cancer Res. 2018;24(6):1296–304.CrossRefPubMed Huang J, Xu B, Mo H, Zhang W, Chen X, Wu D, Qu D, Wang X, Lan B, Yang B, et al. Safety, Activity, and biomarkers of SHR-1210, an Anti-PD-1 antibody, for patients with Advanced Esophageal Carcinoma. Clin Cancer Res. 2018;24(6):1296–304.CrossRefPubMed
24.
go back to reference Melchiorre F, Patella F, Pescatori L, Pesapane F, Fumarola E, Biondetti P, Brambillasca P, Monaco C, Ierardi AM, Franceschelli G, et al. DEB-TACE: a standard review. Future Oncol. 2018;14(28):2969–84.CrossRefPubMed Melchiorre F, Patella F, Pescatori L, Pesapane F, Fumarola E, Biondetti P, Brambillasca P, Monaco C, Ierardi AM, Franceschelli G, et al. DEB-TACE: a standard review. Future Oncol. 2018;14(28):2969–84.CrossRefPubMed
25.
go back to reference Wu B, Zhou J, Ling G, Zhu D, Long Q. CalliSpheres drug-eluting beads versus lipiodol transarterial chemoembolization in the treatment of hepatocellular carcinoma: a short-term efficacy and safety study. World J Surg Oncol. 2018;16(1):69.CrossRefPubMedPubMedCentral Wu B, Zhou J, Ling G, Zhu D, Long Q. CalliSpheres drug-eluting beads versus lipiodol transarterial chemoembolization in the treatment of hepatocellular carcinoma: a short-term efficacy and safety study. World J Surg Oncol. 2018;16(1):69.CrossRefPubMedPubMedCentral
26.
go back to reference Xiang H, Long L, Yao Y, Fang Z, Zhang Z, Zhang Y. CalliSpheres Drug-Eluting bead transcatheter arterial chemoembolization presents with Better Efficacy and Equal Safety compared to conventional TACE in treating patients with Hepatocellular Carcinoma. Technol Cancer Res Treat. 2019;18:1533033819830751.CrossRefPubMedPubMedCentral Xiang H, Long L, Yao Y, Fang Z, Zhang Z, Zhang Y. CalliSpheres Drug-Eluting bead transcatheter arterial chemoembolization presents with Better Efficacy and Equal Safety compared to conventional TACE in treating patients with Hepatocellular Carcinoma. Technol Cancer Res Treat. 2019;18:1533033819830751.CrossRefPubMedPubMedCentral
27.
go back to reference Zhou GH, Han J, Sun JH, Zhang YL, Zhou TY, Nie CH, Zhu TY, Chen SQ, Wang BQ, Yu ZN, et al. Efficacy and safety profile of drug-eluting beads transarterial chemoembolization by CalliSpheres(R) beads in Chinese hepatocellular carcinoma patients. BMC Cancer. 2018;18(1):644.CrossRefPubMedPubMedCentral Zhou GH, Han J, Sun JH, Zhang YL, Zhou TY, Nie CH, Zhu TY, Chen SQ, Wang BQ, Yu ZN, et al. Efficacy and safety profile of drug-eluting beads transarterial chemoembolization by CalliSpheres(R) beads in Chinese hepatocellular carcinoma patients. BMC Cancer. 2018;18(1):644.CrossRefPubMedPubMedCentral
28.
go back to reference Xu J, Shen J, Gu S, Zhang Y, Wu L, Wu J, Shao G, Xu L, Yin T, Liu J, et al. Camrelizumab in Combination with Apatinib in patients with Advanced Hepatocellular Carcinoma (RESCUE): a nonrandomized, Open-label, phase II trial. Clin Cancer Res. 2021;27(4):1003–11.CrossRefPubMed Xu J, Shen J, Gu S, Zhang Y, Wu L, Wu J, Shao G, Xu L, Yin T, Liu J, et al. Camrelizumab in Combination with Apatinib in patients with Advanced Hepatocellular Carcinoma (RESCUE): a nonrandomized, Open-label, phase II trial. Clin Cancer Res. 2021;27(4):1003–11.CrossRefPubMed
Metadata
Title
A retrospective pilot study of transarterial chemoembolisation using camrelizumab-eluting Callisphere beads for unresectable hepatocellular carcinoma
Authors
Xiaonan Shi
Yang Wang
Jianzhuang Ren
Xinwei Han
Yonghua Bi
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11668-7

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