Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC)

Joong Won Park, Deepak Amarapurkar, Yee Chao, Pei Jer Chen, Jean Francois H. Geschwind, Khean Lee Goh, KwangHyub Han, Masatoshi Kudo, Han Chu Lee, Rheun Chuan Lee, Laurentius A. Lesmana, Ho Yeong Lim, Seung Woon Paik, Ronnie T. Poon, Chee Kiat Tan, Tawesak Tanwandee, Gaojun Teng, Ann Lii Cheng

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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.

Original languageEnglish
Pages (from-to)327-337
Number of pages11
JournalLiver International
Volume33
Issue number3
DOIs
Publication statusPublished - 2013 Jan 1

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Hepatocellular Carcinoma
Neoplasm Staging
Expert Testimony
Liver Neoplasms
Tumor Burden
Liver Diseases
Therapeutics
Neoplasm Metastasis
Safety
Survival
Population
Neoplasms

All Science Journal Classification (ASJC) codes

  • Hepatology

Cite this

Park, J. W., Amarapurkar, D., Chao, Y., Chen, P. J., Geschwind, J. F. H., Goh, K. L., ... Cheng, A. L. (2013). Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC). Liver International, 33(3), 327-337. https://doi.org/10.1111/liv.12083
Park, Joong Won ; Amarapurkar, Deepak ; Chao, Yee ; Chen, Pei Jer ; Geschwind, Jean Francois H. ; Goh, Khean Lee ; Han, KwangHyub ; Kudo, Masatoshi ; Lee, Han Chu ; Lee, Rheun Chuan ; Lesmana, Laurentius A. ; Lim, Ho Yeong ; Paik, Seung Woon ; Poon, Ronnie T. ; Tan, Chee Kiat ; Tanwandee, Tawesak ; Teng, Gaojun ; Cheng, Ann Lii. / Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC). In: Liver International. 2013 ; Vol. 33, No. 3. pp. 327-337.
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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.",
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Park, JW, Amarapurkar, D, Chao, Y, Chen, PJ, Geschwind, JFH, Goh, KL, Han, K, Kudo, M, Lee, HC, Lee, RC, Lesmana, LA, Lim, HY, Paik, SW, Poon, RT, Tan, CK, Tanwandee, T, Teng, G & Cheng, AL 2013, 'Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC)', Liver International, vol. 33, no. 3, pp. 327-337. https://doi.org/10.1111/liv.12083

Consensus recommendations and review by an International Expert Panel on Interventions in Hepatocellular Carcinoma (EPOIHCC). / Park, Joong Won; Amarapurkar, Deepak; Chao, Yee; Chen, Pei Jer; Geschwind, Jean Francois H.; Goh, Khean Lee; Han, KwangHyub; Kudo, Masatoshi; Lee, Han Chu; Lee, Rheun Chuan; Lesmana, Laurentius A.; Lim, Ho Yeong; Paik, Seung Woon; Poon, Ronnie T.; Tan, Chee Kiat; Tanwandee, Tawesak; Teng, Gaojun; Cheng, Ann Lii.

In: Liver International, Vol. 33, No. 3, 01.01.2013, p. 327-337.

Research output: Contribution to journalArticle

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AU - Chen, Pei Jer

AU - Geschwind, Jean Francois H.

AU - Goh, Khean Lee

AU - Han, KwangHyub

AU - Kudo, Masatoshi

AU - Lee, Han Chu

AU - Lee, Rheun Chuan

AU - Lesmana, Laurentius A.

AU - Lim, Ho Yeong

AU - Paik, Seung Woon

AU - Poon, Ronnie T.

AU - Tan, Chee Kiat

AU - Tanwandee, Tawesak

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