Addition of Transarterial chemoembolization to Lenvatinib is beneficial in hepatocellular carcinoma

A latest study reported that addition of Transarterial Chemoembolization (TACE) to Lenvatinib (LEN) improves overall survival rate in patients with advanced hepatocellular carcinoma. This study was published in the Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology.

This phase III, multicentre randomized open label study included 338 patients with hepatocellular carcinoma (HCC) who were treatment naïve, or underwent surgery and were diagnosed with initial recurrent advanced HCC recurrent. Patients were randomly assigned to receive LEN (8-12 mg) once daily (LEN group) or LEN along with on-demand TACE (LEN-TACE group). TACE was initiated one day after LEN monotherapy.

At the median follow up of 17, the median overall survival rate was significantly longer in LEN-TACE group (17.8 months) when compared with LEN group (11.5 months). Similar results were obtained for progression-free survival (10.6 months in the LEN-TACE group and 6.4 months in the LEN group) and objective response rate (54.1% v 25.0%).

Based on the results of study, it can be concluded that, addition of TACE to LEN provides significant improvement in the overall survival rate, progression-free survival and objective response rate in hepatocellular cancer patients.

Anastomotic leak testing safe and efficacious in gastric cancer surgery

A recent study found that anastomosis-related complications can be safely and effectively prevented with the help of a comprehensive leak testing procedure in patients who underwent gastric cancer surgery. The study’s results were published in the journal, Surgical endoscopy.

In this prospective, randomized clinical trial that included 138 patients aged between 18 to 85 years, 70 were randomized into the intraoperative leak testing group (IOLT) group while 68 patients were included in the no intraoperative leak testing group (NIOLT). The primary outcome of the study was the incidence of postoperative anastomosis-related complications such as bleeding, leakage, and strictures, in both the groups.

It was found that in the IOLT group, only 5 patients were found to have intraoperative anastomotic defects. Compared to the IOLT group, the NIOLT group showed a greater incidence of postoperative anastomotic leakage i.e. 4 vs 0 patients, respectively. There were no complications seen due to gastroscopy, air, and methylene blue (GAM) leak testing. In a nutshell, it can be concluded that GAM procedure can be safely and effectively performed after a laparoscopic total gastrectomy in patients with gastric cancer.

Ciprofol is superior to Propofol in Painless Gastrointestinal Endoscopy

According to a recent study, appropriate doses of ciprofol outperformed propofol in terms of hemodynamics and respiratory stability during painless gastrointestinal endoscopy, with reduced injection pain, nausea, and vomiting. The findings of this study were published in the journal Drug Design, Development and Therapy.

This was a randomized clinical trial including 149 participants; 63 males and 86 females. The participants were divided into four groups: P-propofol 1.5mg/kg (n=44), C2-ciprofol 0.2mg/kg (n=38), C3-ciprofol 0.3mg/kg (n=36), and C4-ciprofol 0.4mg/kg (n=31). Time was recorded for the disappearance of the eyelash reflex, recovery time, gastrointestinal endoscopy time, and also the Modified Observer’s Assessment of Alertness/Sedation (MOAA/S) score at awakening (T1), 15 minutes (T2) and 30 minutes (T3) post awakening.

Results revealed that the time taken to fall asleep with the three ciprofol groups was significantly shortened, with reduction in nausea and vomiting, when compared to Group P. Thus, ciprofol in varied doses outperformed propofol in hemodynamics and respiratory stability during painless gastrointestinal endoscopy.

Rifaximin soluble solid dispersion IR tablets reduces hospitalization in cirrhosis patients

Rifaximin soluble solid dispersion (SSD) tablets (immediate-release; IR) reduce hospitalization in patients with cirrhosis and shorten the duration of overt hepatic encephalopathy (OHE) treatment, says a recent study. This study was published in the journal, Clinical Gastroenterology and Hepatology.

This randomized, double-blinded, placebo-controlled study was conducted in two trials. During trial 1: outpatients (n=516) with early decompensated cirrhosis were randomly assigned to receive rifaximin SSD once daily in doses of 40 or 80 mg, SER 40 or 80 mg, or 80 mg IR plus SER, or placebo for 24 weeks. During trial 2: Inpatients(71) with OHE were randomly assigned to receive rifaximin SSD: IR 40 mg once or twice daily or SER 80 mg once or twice daily for approximately 14 days, or lactulose with placebo. The primary endpoints assessed in trial 1 and trial 2 [SB1] were time to cirrhosis complication-related hospitalization/all-cause mortality and time to OHE resolution, respectively.

At the end of the trial 1 study, time to all-cause hospitalization/all-cause mortality was reduced with IR 40 mg as compared to the placebo group.  At the end of the trial 2 study, lactulose plus rifaximin SSD IR 40 mg bid significantly reduced the median time to OHE resolution (21.1 hours) compared to lactulose plus placebo.

Based on the results of the study, it can be concluded that rifaximin SSD IR 40 mg may reduce hospitalization in patients with cirrhosis and shorten the duration of OHE during hospitalization.