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Precision Medicine

An Innovative New Approach to Managing Liver Cancers

The Combination of Sorafenib with Transarterial Chemoembolization Improved Overall Survival In Liver Transplant Patients With Unresectable Malignancies
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Houston Methodist researchers have found an innovative approach to liver cancer management that may bring improvements in the treatment of hepatocellular carcinoma (HCC). HCC – which accounts for 850,000 new cases each year and greater than 800,000 deaths – is the sixth most common malignancy worldwide and the third leading cause of cancer-related mortality. Typically, treatment of early HCC includes surgical resection, liver transplantation or local ablation therapy. However, most patients are diagnosed with advanced HCC and hence are not suitable for these curative treatment options. Several hepatology societies including the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases recognize transarterial chemoembolization (TACE) as the standard of care in the treatment of early to intermediate HCC. TACE is a minimally invasive, image-guided, interventional radiology procedure that delivers chemotherapy to the blood vessels supplying the liver tumor. Despite being the recommended treatment modality by most clinical practice guidelines, TACE procedures are required multiple times in a single patient in some cases owing to large tumor volumes and high tumor progression rates – a state referred to as "TACE refractory liver cancer".
Maen Abdelrahim, MD, PhD, associate professor of medicine in oncology at Houston Methodist and director at the Cockrell Center for advanced therapeutics
To circumvent this drawback, Maen Abdelrahim, MD, PhD, associate professor of medicine in oncology at Houston Methodist and director at the Cockrell Center for advanced therapeutics compared a combination therapy of TACE and the drug sorafenib (kinase inhibitor) with TACE monotherapy to treat HCC transplant patients with unresectable HCC. Details of this retrospective study conducted at Houston Methodist between 2008 and 2019 are presented in Cancers in 2022. The combination therapy significantly improved overall survival compared to TACE monotherapy and may provide important clues to advance HCC management, reduce the disease burden and enhance patients’ quality of life.
Maen Abdelrahim, David Victor, Abdullah Esmail, Sudha Kodali, Edward A. Graviss, Duc T. Nguyen, Linda W. Moore, Ashish Saharia, Robert McMillan, Joy N. Fong, Ahmed Uosef, Mahmoud Elshawwaf, Kirk Heyne, and Rafik M. Ghobrial. Transarterial Chemoembolization (TACE) Plus Sorafenib Compared to TACE Alone in Transplant Recipients with Hepatocellular Carcinoma: An Institution Experience. Cancers (Basel). 2022 Feb; 14(3): 650.
Abanti Chattopadhyay, PhD
January 2023
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