Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Iwamoto, Hideki; Shimose, Shigeo; Shirono, Tomotake; Niizeki, Takashi; Kawaguchi, Takumi

doi:.0.0.0

Clin Mol Hepatol > Epub ahead of print

Review

Hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma in the era of chemo-diversity

Hideki Iwamoto^1,2

, Shigeo Shimose¹, Tomotake Shirono¹, Takashi Niizeki¹, Takumi Kawaguchi¹

¹Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
²Iwamoto Internal Medicine Clinic, Kitakyushu, Japan

Correspondence :

Hideki Iwamoto ,
Tel: +81-942-35-3311, Fax: +81-942-317747, Email: iwamoto_hideki@med.kurume-u.ac.jp

Received: November 9, 2022 Revised: January 27, 2023 Accepted: February 9, 2023

ABSTRACT

Recently, treatments for unresectable hepatocellular carcinoma (HCC) have undergone remarkable development. Various systemic chemotherapy drugs have been approved and are recommended by clinical guidelines worldwide. Although systemic treatments are effective and contribute to prolonged patient survival, their effects are unsatisfactory for some specific tumor conditions, such as macrovascular invasion. Hepatic arterial infusion chemotherapy (HAIC) is a traditional treatment for advanced HCC. As yet, there is no worldwide consensus recommending HAIC because no high-quality clinical trials have demonstrated its survival benefit. However, clinical evidence is gradually accumulating that shows its survival benefit, and it is recognized as an effective locoregional treatment for advanced HCC. Several HAIC regimens have been reported, including cisplatin monotherapy, cisplatin plus 5-fluorouracil (low-dose FP), lipiodol-suspended FP, and an oxaliplatin-based regimen. We have entered an era of chemo-diversity in the treatment of advanced HCC. This review aimed to clarify the relevance of HAIC in the era of chemo-diversity. We propose a multidisciplinary therapeutic strategy combining locoregional HAIC treatment with sequential drug therapy, with the aim of becoming cancer-free through conversion therapy.

KeyWords: Hepatocellular carcinoma; Hepatic arterial infusion chemotherapy; Molecular targeted agents; New FP; Locoregional treatment