Patients With Hepatocellular Carcinoma May Benefit From TACE Plus Axitinib
The combination of axitinib and TACE is safe and potentially efficacious for patients with inoperable hepatocellular carcinoma.
Patients with inoperable hepatocellular carcinoma (HCC) may benefit from a combination of transarterial chemoembolization (TACE) and axitinib, according to a study published in Cancer.1
While TACE is a standard of care for patients with inoperable HCC, a post-treatment consequence leading to poor clinical outcomes is the upregulation of angiogenic mediators, particularly vascular endothelial growth factors (VEGFs). The purpose of this study was to determine if adding axitinib, a selective inhibitor of VEGF receptors 1, 2, and 3, to TACE would blunt the VEGF surge and lead to better outcomes.
This single arm, open-label phase 2 study (ClinicalTrials.gov Identifier: NCT01352728) enrolled 50 patients with inoperable HCC who were potential TACE candidates. Patients were given axitinib 5 mg twice daily and were evaluated every 8 weeks for the need for TACE. Axitinib was stopped 24 hours before and after TACE, then resumed. The primary endpoint was 2-year overall survival (OS).
Combining axitinib and TACE resulted in a 2-year OS rate of 43.7%, with a median OS of 18.8 months, which failed to meet the primary endpoint of 2-year OS of 50%.
Hypertension was observed in 24% of patients, and was determined to have prognostic value.
Other commonly observed adverse effects (AE) included hyperbilirubinemia, increase in transaminases, and abdominal pain, which were most likely caused by TACE. Axitinib-related AEs included hand-food skin reactions and hypertension.
The study authors concluded that the combination of axitinib and TACE is safe and potentially efficacious for patients with inoperable HCC. Hypertension was associated with a better OS during treatment.
- Chan SL, Yeo W, Mo F, et al. A phase 2 study of the efficacy and biomarker on the combination of transarterial chemoembolization and axitinib in the treatment of inoperable hepatocellular carcinoma. Cancer. 2017 Jun 22. doi: 10.1002/cncr.30825 [Epub ahead of print]