title: Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC).
abstract: Hepatocellular carcinoma (HCC) presents with a high burden of disease in East Asian countries. Intermediate-stage HCC as defined by the Barcelona Clinic Liver Cancer (BCLC) staging system poses a clinical challenge as it includes a heterogeneous population of patients that can vary widely in terms of tumour burden, liver function and disease aetiology. Intermediate HCC patients often have unsatisfactory clinical outcomes with repeated transarterial chemoembolization (TACE, due to non-response of the target tumour or the development of further metastasis indicating progressive disease. In September 2011, an Expert Panel Opinion on Interventions in Hepatocellular Carcinoma (EPOIHCC) was convened in HK in an attempt to provide a consensus on the practice of TACE. To that end, current clinical practice throughout Asia was reviewed in detail including safety and efficacy data on TACE alone as well as in combination with targeted systemic therapies. This review summarises the evidence discussed at the meeting and provides expert recommendation regarding the available therapeutic options for unresectable intermediate stage HCC. A key consensus of the Expert Panel was that in order to improve patient outcomes and long-term survival, the possibility of using TACE in combination with targeted agents given systemically should be explored. While the currently available clinical data is promising, the expected completion of several pivotal phase II and III RCTs will provide further evidence in support of the rationale for combination therapy regimens.
authors: Centre for Liver Cancer, National Cancer Center Hospital, Seoul, Korea.
authors: Joong-Won
authors: JW
authors: Park
authors: Deepak
authors: D
authors: Amarapurkar
authors: Yee
authors: Y
authors: Chao
authors: Pei-Jer
authors: PJ
authors: Chen
authors: Jean-Francois H
authors: JF
authors: Geschwind
authors: Khean Lee
authors: KL
authors: Goh
authors: Kwang-Hyub
authors: KH
authors: Han
authors: Masatoshi
authors: M
authors: Kudo
authors: Han Chu
authors: HC
authors: Lee
authors: Rheun-Chuan
authors: RC
authors: Lee
authors: Laurentius A
authors: LA
authors: Lesmana
authors: Ho Yeong
authors: HY
authors: Lim
authors: Seung Woon
authors: SW
authors: Paik
authors: Ronnie T
authors: RT
authors: Poon
authors: Chee-Kiat
authors: CK
authors: Tan
authors: Tawesak
authors: T
authors: Tanwandee
authors: Gaojun
authors: G
authors: Teng
authors: Ann-Lii
authors: AL
authors: Cheng
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use*; D044466:Asian People; D006528:Carcinoma, Hepatocellular / Q000208:ethnology / Q000628:therapy*; D016461:Chemoembolization, Therapeutic / Q000379:methods* / Q000592:standards*; D006801:Humans; D008113:Liver Neoplasms / Q000208:ethnology / Q000628:therapy*; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib