This project involves the collection and analysis of retrospective and prospective data on patients diagnosed with hepatocellular carcinoma (HCC) in which the Surefire Precision Infusion System was used/will used be to deliver transarterial chemoembolization with doxorubicin-eluting beads (DEB-TACE). The purpose is to compare tumor and medical response in a real-world setting as well as identify potential areas for future clinical research.
Conventional transarterial chemoembolization with lipiodol/doxorubicin (cTACE) is known to prolong survival compared to supportive therapy in certain patients with unresectable HCC, including patients with unilateral portal vein invasion (PVI). The best results for cTACE occur when the dose is delivered in a highly targeted manner into the tumor. Dense accumulation of embolic spheres or lipiodol into the tumor as documented by computed tomography (CT) has been shown to have improved outcomes. However, with standard endhole catheters, achieving maximum delivery of embolic agents is significantly limited by the development of stasis, non-target delivery and subsequent non-target injury. Thus, when this procedure is performed with endhole catheters, there is significant variability in the delivery of the agent that is entirely dependent on the flow pattern of the target tumor. Therefore, current techniques result in various degrees of embolization with variability in dosages and angiographic endpoints. DEB-TACE is a relatively new modality associated with favorable systemic doxorubicin exposure/toxicity and liver-specific toxicity compared to cTACE. It is currently utilized for: (1) patients who have unresectable HCC; (2) patients who meet the Milan Criteria and are currently on liver transplantation lists; and (3) downstaging patients into Milan Criteria for possible liver transplantation.
Study Type
OBSERVATIONAL
Enrollment
111
Subjects have undergone/will undergo DEB-TACE using the Surefire Precision Infusion System.
UCLA
Los Angeles, California, United States
USC
Los Angeles, California, United States
UCSD
San Diego, California, United States
Medstar Georgetown University Hospital
Objective tumor response
Time frame: 6 months following initial DEB-TACE procedure.
Objective tumor response
Time frame: 1 and 3 months following initial DEB-TACE procedure
Dose of doxorubicin-eluting beads used during DEB-TACE procedure(s)
Time frame: 6 months following initial DEB-TACE procedure
Tumor characteristics
Number of lesions, location of lesions (uni-lobar versus bi-lobar), and distribution (unifocal, multi-focal, diffuse)
Time frame: DEB-TACE procedure(s)
Size of doxorubicin-eluting beads used during DEB-TACE procedure(s)
Time frame: DEB-TACE procedure(s)
Changes in alpha-fetoprotein (AFP) blood levels
Time frame: 1, 3 and 6 months following initial DEB-TACE procedure
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Washington D.C., District of Columbia, United States
Florida Hospital
Orlando, Florida, United States
Sarasota Memorial Hospital
Sarasota, Florida, United States
University of Maryland Medical Center
Baltimore, Maryland, United States
Cleveland Clinic Foundation
Cleveland, Ohio, United States
University Hospitals of Cleveland
Cleveland, Ohio, United States
University of Utah
Salt Lake City, Utah, United States