Radiopaque beads loaded with doxorubicin in the treatment of patients with hepatocellular carcinoma: A retrospective, multi-center study

Background and aims: Radiopaque drug-eluting beads are an emerging treatment option for patients with hepatocellular carcinoma (HCC). The primary objective of this study was to evaluate overall disease and target tumor response of non-resectable HCC after TACE with a doxorubicin-loaded radiopaque microsphere. Methods: Data were abstracted from records of patients with unresectable HCC who received TACE with doxorubicin-loaded radiopaque LC Bead LUMI^TM microspheres at one of five United States centers between February 2016 - November 2017. Response was measured using modified response criteria in solid tumors. Primary efficacy endpoints included objective response rate (ORR) and disease control rate (DCR) at first assessment post-treatment, both overall and for targeted tumors. ORR was the sum of complete and partial response. DCR was ORR plus stable disease. Toxicity was calculated using common terminology criteria for adverse events. Results: Eighty-two patients were included. Overall ORR and DCR were 47.6% (39/82) and 76.8% (63/82), respectively. ORR and DCR of target tumors were 56% and 98%, respectively. Five patients experienced adverse events (5/82, 6.1%). No grade 4-5 toxicities occurred. Conclusions: TACE with drug-loaded radiopaque beads is a promising treatment for unresectable HCC. Prospective studies should evaluate whether radiopaque beads reduce off-target distribution of microspheres.