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Liver transarterial chemoembolization and sunitinib for unresectable hepatocellular carcinoma: Results of the PRODIGE 16 study - 20/04/21

Doi : 10.1016/j.clinre.2020.05.012 
Anthony Turpin a, , Thierry de Baere b, Alexandra Heurgué c, Karine Le Malicot d, t, Isabelle Ollivier-Hourmand e, Thierry Lecomte f, Hervé Perrier g, Julien Vergniol h, David Sefrioui i, Yves Rinaldi j, Julien Edeline k, Jean-Louis Jouve l, Christine Silvain m, Yves Becouarn n, Barbara Dauvois o, Mathieu Baconnier p, Maryline Debette-Gratien q, Gael Deplanque r, Sébastien Dharancy s, Côme Lepage l, t, Mohamed Hebbar a
for the

PRODIGE 16 investigators Collaborators1

  See list of investigators/collaborators in supplementary appendix.

a Department of Medical Oncology, University Hospital, Lille, France 
b Department of Surgical Radiology, Gustave Roussy Institute, Villejuif, France 
c Department of Hepato-Gastroenterology, University Hospital Robert Debré, Reims, France 
d Statistics Department, Fédération Francophone de cancérologie Digestive, Dijon, France 
e Department of Hepato-Gastroenterology and Nutrition, University Hospital Côte de Nacre, Caen, France 
f Department of Hepato-Gastroenterology, University Hospital, Tours, France 
g Department of Hepato-Gastroenterology and Oncology, Saint-Joseph Hospital, Paris, France 
h Department of Hepato-Gastroenterology, University Hospital, Pessac, France 
i Inserm 1245, IRON group, Hepato-Gastroenterology unit, University Hospital, Rouen, France 
j Oncology Unit, European Hospital, Marseille, France 
k Department of Medical Oncology, Eugène Marquis center, Rennes, France 
l Department of Hepato-Gastroenterology, University Hospital François Mitterrand, Dijon, France 
m Hepato-Gastroenterology Unit, University Hospital, Poitiers, France 
n Digestive Tumours Unit, Bergonié Institute, Bordeaux, France 
o Department of Hepato-gastroenterology, La Source Hospital, Orléans, France 
p Gastroenterology Department, CH Annecy Genevois, Pringy, France 
q Department of Hepato-Gastroenterology, University Hospital Dupuytren, Limoges, France 
r Medical Oncology, Saint Joseph Hospital, Paris, France 
s Department of Hepato-Gastroenterology, inserm U995, University Hospital, Lille, France 
t EPICAD inserm LNC-UMR 1231, University of Burgundy and Franche-Comté, Dijon, France 

Corresponding author at: Hôpital Claude Huriez, 1, rue Polonovski, 59037 Lille, France.Hôpital Claude Huriez1, rue PolonovskiLille59037France

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Highlights

TACE+sunitinib in the 1st-line therapy was feasible in HCC.
No bleeding complication observed in both arms.
Compliance to sunitinib was acceptable.
In the era of immunotherapy, TACE-combined therapies research is needed.

Il testo completo di questo articolo è disponibile in PDF.

Summary

Background

Trans-arterial chemoembolization (TACE) is one first-line option therapy for patients with hepatocellular carcinoma (HCC) not suitable for surgical resection.

Aims

We evaluated the effects of sunitinib plus doxorubicin-TACE on bleeding or liver failure.

Methods

Seventy-eight patients with HCC were included in this randomized, double-blind study. They received one to three TACE plus either sunitinib or placebo four weeks out of six for one year. The occurrence of severe bleeding or liver failure was assessed during the week after the TACE. The safety and survival outcomes were evaluated.

Results

No bleeding complication was reported. One and two liver failures were respectively observed in sunitinib and placebo patients. Compliance to sunitinib treatment was acceptable. Sunitinib dose reduction occurred in 37% of patients due to acute toxicity. Main grade 3–4 toxicities were: thrombocytopenia, neutropenia, increased bilirubin, increased ALT and asthenia. In the sunitinib group, the median PFS and OS were 9.05 [5.81;11.63] and 25.0 [13.5;36.8] months, respectively. In the placebo group, the median PFS and OS were 5.51 [4.14;7.79] and 20.5 [15.1;30.6] months, respectively.

Conclusions

TACE plus sunitinib in the first-line therapy for patients with HCC not suitable for surgical resection was feasible.

ClinicalTrials.gov number

NCT01164202.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Transarterial chemoembolization, Sunitinib, Hepatocellular carcinoma, Liver failure, Bleeding complications

Abbreviations : HCC, TACE, VEGF, PFS, OS, EASL, ITT, mITT, CI


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