Prognostic value of vascular endothelial growth factor in both conventional and drug eluting beads transarterial chemoembolization for treatment of unresectable hepatocellular carcinoma in HCV patients

Expert Rev Gastroenterol Hepatol. 2020 Dec;14(12):1203-1214. doi: 10.1080/17474124.2020.1823215. Epub 2020 Sep 29.

Abstract

Objectives: This work aimed to measure serum vascular endothelial growth factor (VEGF) levels before and after Conventional transarterial chemoembolization (cTACE) versus drug-eluting beads (DEB)-TACE and evaluate its efficacy in predicting response to therapy and tumor recurrence.

Methods: 114 patients with unresectable hepatocellular carcinoma complicating hepatitis C virus-related cirrhosis were included. They underwent cTACE (58) or DEB-TACE (56). VEGF serum levels were measured before and on days 1 and 30 after TACE. Patients with complete response (CR) after TACE were followed-up for one year. Statistical analysis was done.

Results: VEGF level was higher than baseline after cTACE (P < 0.001), and DEB-TACE (P = 0.004). It was also significantly higher in patients with progressive disease (P < 0.001). VEGF level at cut off values of 97.3, 149.8, and 104.1 pg/ml could discriminate disease progression from treatment success with area under ROC curves of 0.806, 0.775, and 0.771, respectively. The sensitivity was 88.9%, 88.9%, and 77.8% and specificity was 62.5%, 64.6 and 66.7%, respectively. However, no relation to tumor recurrence in CR group could be detected after one year.

Conclusion: VEGF serum levels may predict response to therapy in patients treated by DEB-TACE or cTACE but it has no relation to tumor recurrence.

Keywords: DEB-TACE; HCC; VEGF; cTACE; prognosis; unresectable HCC.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antibiotics, Antineoplastic / administration & dosage*
  • Biomarkers, Tumor / blood
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / diagnostic imaging
  • Carcinoma, Hepatocellular / etiology
  • Carcinoma, Hepatocellular / therapy*
  • Chemoembolization, Therapeutic / methods*
  • Doxorubicin / administration & dosage*
  • Female
  • Hepatitis C, Chronic / complications
  • Humans
  • Liver Cirrhosis / etiology
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnostic imaging
  • Liver Neoplasms / etiology
  • Liver Neoplasms / therapy*
  • Male
  • Microspheres
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Treatment Outcome
  • Vascular Endothelial Growth Factor A / blood*

Substances

  • Antibiotics, Antineoplastic
  • Biomarkers, Tumor
  • Vascular Endothelial Growth Factor A
  • Doxorubicin