Hepatocellular Carcinoma Clinical Trial
Official title:
Surefire Precision Infusion System Registry
This project involves the collection and analysis of retrospective and prospective data on patients diagnosed with hepatocellular carcinoma (HCC) in which the Surefire Precision Infusion System was used/will used be to deliver transarterial chemoembolization with doxorubicin-eluting beads (DEB-TACE). The purpose is to compare tumor and medical response in a real-world setting as well as identify potential areas for future clinical research.
Conventional transarterial chemoembolization with lipiodol/doxorubicin (cTACE) is known to
prolong survival compared to supportive therapy in certain patients with unresectable HCC,
including patients with unilateral portal vein invasion (PVI). The best results for cTACE
occur when the dose is delivered in a highly targeted manner into the tumor. Dense
accumulation of embolic spheres or lipiodol into the tumor as documented by computed
tomography (CT) has been shown to have improved outcomes. However, with standard endhole
catheters, achieving maximum delivery of embolic agents is significantly limited by the
development of stasis, non-target delivery and subsequent non-target injury. Thus, when this
procedure is performed with endhole catheters, there is significant variability in the
delivery of the agent that is entirely dependent on the flow pattern of the target tumor.
Therefore, current techniques result in various degrees of embolization with variability in
dosages and angiographic endpoints.
DEB-TACE is a relatively new modality associated with favorable systemic doxorubicin
exposure/toxicity and liver-specific toxicity compared to cTACE. It is currently utilized
for: (1) patients who have unresectable HCC; (2) patients who meet the Milan Criteria and are
currently on liver transplantation lists; and (3) downstaging patients into Milan Criteria
for possible liver transplantation.
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