Prospective Study to Evaluate Safety of Deb-TACE With 100µ Beads in Patients With Non Resectable HCC

Instituto de Investigación Sanitaria de la Fundación Jiménez Díaz131 enrolled

Overview

This is an observational, multicenter, single arm, prospective study to evaluate safety and tolerability of selective and ultraselective drug eluting beads transcatheter intraarterial chemoembolization (DEB-TACE) with up to 3 ml of well calibrated 100 µ microspheres and up to 150 mg of doxorubicin, for the treatment of non resectable hepatocellular carcinoma (HCC). The hypothesis is that 100 µ beads penetrate deeper into the tumor than those eluting beads with larger volumes without increasing the risk and complications of DEB-TACE.

In this observational, prospective study patients will undergo DEB-TACE and subsequent follow up procedures according to standard clinical practice. The primary aim of the study is to describe treatment safety and tolerability of 100 µ beads in DEB-TACE. As a secondary end-point a description of efficacy parameters will be obtained.

Study Type

OBSERVATIONAL

Enrollment

131

Conditions

Hepatocellular Carcinoma

Interventions

DEB-TACEDEVICE

Selective and ultraselective transcatheter intraarterial administration up to 3ml of well calibrated 100µ drug eluting microspheres with up to 150 mg of doxorubicin.

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patients with a diagnosis of HCC according to European Association for the Study of the Liver (EASL) and American Association for the Study of Liver Diseases (AASLD) criteria and staged by BCLC criteria 2. Indication for receiving transarterial chemoembolization DEB-TACE with 100 µ microspheres according to usual clinical practice. 3. Able and willing to participate and give their written informed consent. 4. Both genders and ≥ 18 years old. 5. Eastern Cooperative Oncology Group (ECOG) 0 6. Preserved hepatic function (Child-Pugh ≤ B7). 7. No evidence of tumoral invasion in portal vein or main biliary ducts. 8. Able to go through image diagnostic techniques such as CT or MRI. 9. Preserved cardiac and renal function. 10. No concomitant active infections that require antibiotic treatment. 11. Measurable disease according to mRECIST criteria. 12. Life expectancy over 6 months. Exclusion Criteria: 1. ECOG ≥ 1 2. Child-Pugh ≥B8. 3. Presence of ascitis or encephalopathy 4. Extrahepatic tumoral disease. 5. Tumoral vascular invasion 6. Serum bilirubin\>3 mg/dl. 7. Cr Clearance ≤ 60 ml/min 8. If any of the following is contraindicated: 1. Administration of doxorubicin 2. Iodated contrasts 3. CT or MRI procedures 4. Transarterial embolization procedures 5. White blood cells (WBC) \< 2000 /mm3 6. Neutrophil count \< 1500 /mm3 7. Ejection fraction \< 50 % 8. Platelet count \< 5 x 104/mm3, international normalized ratio (INR) \> 2,0) 9. Transaminases (AST and/or ALT) \> 5x upper limit of normal or \>250 u/l 10. Known hepatofugal portal vein flow 11. A-V intrahepatic macroscopic fistula 9. Pregnant or breast feeding women. 10. Tumor burden involving more than 50% of the liver. 11. Active bacterial or fungal infection. 12. Other concomitant tumors. 13. Any other condition that according to investigator criteria, contraindicates DEB-TACE. 14. Patients not willing to participate and/or give their written informed consent.

Outcomes

Primary Outcomes

Safety and Tolerability

Major and minor complications, procedure related mortality and post-embolisation syndrome after DEB-TACE of non-resectable HCC, using 100-µm doxorubicin-loaded microspheres

Time frame: 30 days

Secondary Outcomes

Tumor Response

Devascularization pattern in the treated tumor, assessed with the modified RECIST (mRECIST), in the contrast enhanced liver CT or MR obtained during FU.

Time frame: 6 months, 1 year, 2 year

Overall survival

Time frame: 2 years