Intra-Arterial Therapy Promising for Intrahepatic Chloangiocarcinoma

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(ChemotherapyAdvisor) – Intra-arterial therapy (IAT) is associated with promising locoregional control rates among patients with intrahepatic chloangiocarcinoma (ICC), according to a retrospective database analysis presented at the 66th Annual Society of Surgical Oncology (SSO) Cancer Symposium in National Harbor, MD.

“IAT for ICC was safe and provided good locoregional control of disease in up to three-quarters of patients,” reported Omar Hydar, MD, of Johns Hopkins University, Baltimore, MD and his coauthors. “Among patients with an IAT response, overall survival was prolonged.”

Patients with intrahepatic cholangiocarcinoma frequently present with advanced, inoperable disease and have traditionally been treated with systematic chemotherapy, Dr. Hydar's team noted. But despite increasing interest in the use of locoregional therapy, data on IAT's safety and efficacy for ICC remains “limited,” the authors noted.

To assess response, morbidity, and survival rates for patients undergoing IAT for ICC, the coauthors searched a multi-institutional database and identified 153 such patients who had been treated between 1993 and 2012. The median age of patients at diagnosis was 61 years.

“Median tumor size was 9.6 cm and 46% of patients had a solitary lesion; 26% of patients had extrahepatic disease and 11% had a prior surgical resection,” the authors noted. “IAT consisted of standard transarterial chemoembolization (TACE, 84%), bland TAE (9%), or drug-eluting beads (DEB, 7%).”

“Median overall survival was 12 months and did not differ based on type of IAT (TACE, 12 months vs. TAE 14 months vs. DEB 10 months; P=0.75),” the coauthors reported.

Improved overall survival was associated with larger numbers of IAT sessions and IAT response (P < 0.05).

Tumor response was complete or partial in 24% of patients; 52% had stable disease.

“There were 18 peri-procedural complications for a morbidity of 12%; most complications were minor (n=13),” the researchers reported. However, five patients experienced grade 3/4 complications, they noted.

“The role of IAT therapy for ICC warrants further prospective evaluation in clinical trials,” the researchers concluded.

The abstract (#5) for this presentation is available at the 66th Annual SSO Cancer Symposium's website.

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