Hepatocellular carcinoma with portal venous invasion : Radiating new hope ?
Mené sur 90 patients atteints d'un carcinome hépatocellulaire avec envahissement vasculaire macroscopique (âge médian : 55 ans ; 77 hommes), cet essai évalue l'efficacité, du point de vue de la survie sans progression à 12 semaines, et la sécurité d'une chimio-embolisation transartérielle en combinaison avec une radiothérapie externe par rapport au sorafénib
The growing incidence of hepatocellular carcinoma (HCC) is a major global public health challenge. The mortality rate for HCC is very high, and most available treatment options remain palliative. Early-stage HCC can be treated with curative intent with transplantation, resection, or ablation. Level 1 evidence from randomized clinical trials has demonstrated a survival advantage for transarterial chemoembolization (TACE) vs supportive care for intermediate-stage HCC1 and for systemic therapy with sorafenib, lenvatinib, regorafenib, and cabozantinib for advanced-stage HCC.1,2 Recently, immune checkpoint inhibitors have demonstrated impressive antitumor activity with high response rates in advanced HCC, and phase 3 trials are ongoing to assess survival benefits.3,4
JAMA Oncology , commentaire en libre accès, 2017