The following article features coverage from the American Society of Clinical Oncology 2020 meeting. Click here to read more of Cancer Therapy Advisor‘s conference coverage.

Stereotactic body radiation therapy (SBRT) was as effective as transarterial chemoembolization (TACE) as a bridging therapy for patients with low-volume hepatocellular carcinoma (HCC) undergoing liver transplant, according to a recent study.

“In early stage HCC, in patients with good hepatic function SBRT and TACE appear to be equally effective,” said Francis W. Nugent, MD, of Beth Israel/Lahey Health in Burlington, Massachusetts, who presented the results as during the ASCO20 Virtual Scientific Program. “Quality of life may be better preserved in patients who undergo SBRT compared with TACE and it also eliminates the need for hospitalization.”

The prospective study included 54 patients with CTP Class A/B8 cirrhosis who were randomly assigned to TACE or SBRT as a bridge to transplant. Patients assigned to TACE were scheduled to receive 2 treatments 1 month apart using DEBDOX beads and were hospitalized after each TACE. Patients assigned to SBRT (21 patients) received a median total dose of 45 Gy delivered over 5 fractions.

The primary endpoint was time to recurrent or residual disease. For SBRT the median time to recurrent disease was 10.4 months compared with 9.3 months for TACE.


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Major toxicities data were modest. Both TACE and SBRT were well-tolerated treatments. One patient undergoing TACE developed portal vein thrombosis as well as infarction of the liver, Dr Nugent explained. And for SBRT, there were no toxicities.

Of the 19 patients that underwent TACE, 8 patients had a pathologic complete response (42%). Of the 12 SBRT patients who underwent transplant, 4 patients achieved CR (33%).

Quality of life outcomes were assessed via questionnaire. Both physical and cognitive outcomes favored SBRT.

Read more of Cancer Therapy Advisor‘s coverage of the ASCO 2020 meeting by visiting the conference page.

Reference

Nugent FW, Hunter K, Molgaard C, et al. A randomized phase II feasibility study of individualized stereotactic body radiation therapy (SBRT) versus transarterial chemoembolization (TACE) with DEBDOX beads as a bridge to transplant in hepatocellular carcinoma (HCC). Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr 4586.