中期肝细胞癌TACE联合索拉非尼治疗结果—SPACE研究分析.pptx

读书汇报;;Intermediate stage (Barcelona clinic liver cancer stage B) HCC;Background Aims;Why choose DEB-TACE？;Patients were included if:;Patients were excluded if：;Study protocol;Interruptions and reductions; Time to unTACEable progression (TTUP);Kudo M, Matsui O, Izumi N, et al. Transarterial chemoembolization failure/refractoriness: JSH-LCSGJ criteria 2014 update. Oncology. 2014. 87 Suppl 1: 22-31.;;;;Results of the SPACE trial;Time-to-progression (TTP);Time to macrovascular invasion/extrahepatic spread (MVI/EHS);Time to unTACEable progression (TTUP);Overall survival (OS);;;Safety;Four deaths in the sorafenib arm (two due to hepatobiliary/liver dysfunction and one each to constitutional (unspecified) and syndromeother (unspecified)) One death in the placebo arm (due to perforation of the duodenum); Summary;Thinking;TACE and Sorafenib: A Good Marriage?;① The dose modification and treatment discontinuation;② The high biological heterogeneity across HCC;③ The timing of antiangiogenic therapy with sorafenib;The first two models address the risk of bleeding from continuing sorafenib at the time of an invasive vascular procedure like TACE or DEB-TACE. The third continuous administration approach, as yet untested clinically, aims at inhibiting the surge of VEGF after embolization that rises to approximately 160% of the baseline level on day 1, and falls back to 130% and 120% on days 2 and 3, respectively. The optimal clinical approach will depend on the balance between safety and efficacy. ;④ The best way to assess outcome (embolization + sorefenib);⑤ The definition of efficacy;In conclusion;THANK YOU!