Gong Yang
Faculty Member
Last active: 4/27/2017

A nonrandomized cohort and a randomized study of local control of large hepatocarcinoma by targeting intratumoral lactic acidosis.

Chao M, Wu H, Jin K, Li B, Wu J, Zhang G, Yang G, Hu X
Elife. 2016 5

PMID: 27481188 · PMCID: PMC4970867 · DOI:10.7554/eLife.15691

STUDY DESIGN - Previous works suggested that neutralizing intratumoral lactic acidosis combined with glucose deprivation may deliver an effective approach to control tumor. We did a pilot clinical investigation, including a nonrandomized (57 patients with large HCC) and a randomized controlled (20 patients with large HCC) studies.

METHODS - The patients were treated with transarterial chemoembolization (TACE) with or without bicarbonate local infusion into tumor.

RESULTS - In the nonrandomized controlled study, geometric mean of viable tumor residues (VTR) in TACE with bicarbonate was 6.4-fold lower than that in TACE without bicarbonate (7.1% [95% CI: 4.6%-10.9%] vs 45.6% [28.9%-72.0%]; p<0.0001). This difference was recapitulated by a subsequent randomized controlled study. TACE combined with bicarbonate yielded a 100% objective response rate (ORR), whereas the ORR treated with TACE alone was 44.4% (nonrandomized) and 63.6% (randomized). The survival data suggested that bicarbonate may bring survival benefit.

CONCLUSION - Bicarbonate markedly enhances the anticancer activity of TACE.Clinical trail registration: ChiCTR-IOR-14005319.

MeSH Terms (15)

Acidosis, Lactic Adult Aged Aged, 80 and over Bicarbonates Carcinoma Chemoembolization, Therapeutic Combined Modality Therapy Female Humans Liver Neoplasms Male Middle Aged Survival Analysis Treatment Outcome

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