UNLABELLED: The aim of this study was to compare radiological and pathological changes and test the adjunct efficacy of Sorafenib to Y90 as a bridge to transplantation in hepatocellular carcinoma (HCC). 15 patients with 16 HCC lesions were randomized to Y90 without (Group A, n = 9) or with Sorafenib (Group B, n = 7). Size (WHO, RECIST), enhancement (EASL, mRECIST) and diffusion-weighted imaging criteria (apparent diffusion coefficient, ADC) measurements were obtained at baseline, then at 1 and every 3 months after treatment until transplantation. Percentage necrosis in explanted tumors was correlated with imaging findings. 100%, 50%-99% and <50% pathological necrosis was observed in 6 (67%), 1 (11%), and 2 (22%) tumors in Group A and 3 (42%), 2 (28%), and 2 (28%) in Group B, respectively (P = 0.81). While ADC (P = 0.46) did not change after treatment, WHO (P = 0.06) and RECIST (P = 0.08) response at 1 month failed to reach significance, but significant responses by EASL (P < 0.01/0.03) and mRECIST (P < 0.01/0.03) at 1 and 3 months were observed. Response was equivalent by EASL or mRECIST. No difference in response rates was observed between groups A and B at 1 and 3 months by WHO, RECIST, EASL, mRECIST or ADC measurements. Despite failing to reach significance, smaller baseline size was associated with complete pathological necrosis (CPN) (RECIST: P = 0.07; WHO: P = 0.05). However, a cut-off size of 35 mm was predictive of CPN (P = 0.005). CPN could not be predicted by WHO (P = 0.25 and 0.62), RECIST (P = 0.35 and 0.54), EASL (P = 0.49 and 0.46), mRECIST (P = 0.49 and 0.60) or ADC (P = 0.86 and 0.93). CONCLUSION: The adjunct of Sorafenib did not augment radiological or pathological response to Y90 therapy for HCC. Equivalent significant reduction in enhancement at 1 and 3 months by EASL/mRECIST was noted. Neither EASL nor mRECIST could reliably predict CPN.
RCT Entities:
UNLABELLED: The aim of this study was to compare radiological and pathological changes and test the adjunct efficacy of Sorafenib to Y90 as a bridge to transplantation in hepatocellular carcinoma (HCC). 15 patients with 16 HCC lesions were randomized to Y90 without (Group A, n = 9) or with Sorafenib (Group B, n = 7). Size (WHO, RECIST), enhancement (EASL, mRECIST) and diffusion-weighted imaging criteria (apparent diffusion coefficient, ADC) measurements were obtained at baseline, then at 1 and every 3 months after treatment until transplantation. Percentage necrosis in explanted tumors was correlated with imaging findings. 100%, 50%-99% and <50% pathological necrosis was observed in 6 (67%), 1 (11%), and 2 (22%) tumors in Group A and 3 (42%), 2 (28%), and 2 (28%) in Group B, respectively (P = 0.81). While ADC (P = 0.46) did not change after treatment, WHO (P = 0.06) and RECIST (P = 0.08) response at 1 month failed to reach significance, but significant responses by EASL (P < 0.01/0.03) and mRECIST (P < 0.01/0.03) at 1 and 3 months were observed. Response was equivalent by EASL or mRECIST. No difference in response rates was observed between groups A and B at 1 and 3 months by WHO, RECIST, EASL, mRECIST or ADC measurements. Despite failing to reach significance, smaller baseline size was associated with complete pathological necrosis (CPN) (RECIST: P = 0.07; WHO: P = 0.05). However, a cut-off size of 35 mm was predictive of CPN (P = 0.005). CPN could not be predicted by WHO (P = 0.25 and 0.62), RECIST (P = 0.35 and 0.54), EASL (P = 0.49 and 0.46), mRECIST (P = 0.49 and 0.60) or ADC (P = 0.86 and 0.93). CONCLUSION: The adjunct of Sorafenib did not augment radiological or pathological response to Y90 therapy for HCC. Equivalent significant reduction in enhancement at 1 and 3 months by EASL/mRECIST was noted. Neither EASL nor mRECIST could reliably predict CPN.
Authors: Daniel Spira; Michael Fenchel; Ulrich M Lauer; Claus D Claussen; Michael Gregor; Michael Bitzer; Marius Horger Journal: Acad Radiol Date: 2010-10-06 Impact factor: 3.173
Authors: Riad Salem; Robert J Lewandowski; Laura Kulik; Edward Wang; Ahsun Riaz; Robert K Ryu; Kent T Sato; Ramona Gupta; Paul Nikolaidis; Frank H Miller; Vahid Yaghmai; Saad M Ibrahim; Seanthan Senthilnathan; Talia Baker; Vanessa L Gates; Bassel Atassi; Steven Newman; Khairuddin Memon; Richard Chen; Robert L Vogelzang; Albert A Nemcek; Scott A Resnick; Howard B Chrisman; James Carr; Reed A Omary; Michael Abecassis; Al B Benson; Mary F Mulcahy Journal: Gastroenterology Date: 2010-10-30 Impact factor: 22.682
Authors: Ahsun Riaz; Khairuddin Memon; Frank H Miller; Paul Nikolaidis; Laura M Kulik; Robert J Lewandowski; Robert K Ryu; Kent T Sato; Vanessa L Gates; Mary F Mulcahy; Talia Baker; Ed Wang; Ramona Gupta; Ritu Nayar; Al B Benson; Michael Abecassis; Reed Omary; Riad Salem Journal: J Hepatol Date: 2010-10-23 Impact factor: 25.083
Authors: Christina Schraml; Nina F Schwenzer; Petros Martirosian; Michael Bitzer; Ulrich Lauer; Claus D Claussen; Marius Horger Journal: AJR Am J Roentgenol Date: 2009-10 Impact factor: 3.959
Authors: Giuseppe Maria Ettorre; Giovanni Battista Levi Sandri; Andrea Laurenzi; Marco Colasanti; Roberto Luca Meniconi; Raffaella Lionetti; Roberto Santoro; Pasquale Lepiane; Rosa Sciuto; Giuseppe Pizzi; Roberto Cianni; Rita Golfieri; Gianpiero D'Offizi; Adriano M Pellicelli; Mario Antonini; Giovanni Vennarecci Journal: World J Surg Date: 2017-01 Impact factor: 3.352
Authors: Michael Lock; Ashkan A Malayeri; Omar Y Mian; Nina A Mayr; Joseph M Herman; Simon S Lo Journal: Future Oncol Date: 2016-08-31 Impact factor: 3.404
Authors: Ahmed Gabr; Ahsun Riaz; Guy E Johnson; Edward Kim; Siddharth Padia; Robert J Lewandowski; Riad Salem Journal: Eur J Nucl Med Mol Imaging Date: 2020-08-04 Impact factor: 9.236