Deterioration of liver function after transarterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): An exploratory analysis of OPTIMIS—An international observational study assessing the use of sorafenib after TACE.

Abstract

368 Background: TACE is commonly used for patients (pts) with unresectable HCC, and appropriate pt selection is important to obtain optimal outcomes. However, there is no globally accepted consensus on unsuitability and refractoriness to TACE. Retrospective studies suggest that continuing TACE after refractoriness or failure is harmful and may cause pts to become ineligible for further treatments because of liver function deterioration. This exploratory analysis of OPTIMIS evaluated the real-world incidence of liver function deterioration by baseline liver characteristics after first TACE. Methods: OPTIMIS enrolled 1670 pts with HCC for whom a decision to treat with TACE was made at the time of study entry. Liver function deterioration was defined as worsening of CTCAE grade compared with baseline for any of these parameters: aspartate aminotransferase (AST), alanine aminotransferase (ALT), total bilirubin, albumin, and prothrombin international normalized ratio (INR). All analyses are descriptive. Results: A total of 977 pts received TACE. The incidence of liver deterioration was higher in pts with BCLC stage C vs stage B (52% vs 44%, respectively), in pts exceeding the up-to-7 criteria compared with those within (49% vs 43%, respectively), and in those deemed unsuitable for TACE at baseline versus those deemed eligible (53% vs 44%, respectively) (Table). Conclusions: Deterioration of liver function parameters was observed after TACE in pts with HCC in the real-world setting. Therefore, appropriate pt selection for TACE and preserving liver function are important to optimize the benefit of TACE and subsequent treatments. Clinical trial information: NCT01933945. [Table: see text]