Transarterial Embolization Alone Versus Drug-Eluting Microspheres Chemoembolization for Hepatocellular Carcinoma (RAD-18-TAcE): A Multicenter Randomized Clinical Trial.
Cristina Mosconi, Makoto Taninokuchi Tomassoni, Sara Zanella et al.
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In 30 seconds
This multicenter randomized non-inferiority trial compared transarterial embolization (TAE) with drug-eluting microspheres chemoembolization (DEM-TACE) in patients with unresectable hepatocellular carcinoma. Among 111 participants, median time to progression was similar: 7.56 months with TAE versus 7.98 months with DEM-TACE (p = 0.432). In patients with confirmed progression, the mean difference in time to progression was 1.75 months (95% CI - 1.47-4.97), within the predefined equivalence range; TOST analysis supported equivalence. Survival, tumor response, adverse events, and hospitalization were also not statistically different.
Key findings
- Median time to progression was 7.56 months with TAE and 7.98 months with DEM-TACE (p = 0.432).
- For confirmed progression, the mean time-to-progression difference was 1.75 months (95% CI - 1.47-4.97), within the predefined equivalence range.
- Overall survival, tumor response rates, and adverse events did not differ statistically between groups (p > 0.05 for each outcome).
- Median hospitalization was 4 days in both groups (p = 0.638).
Why it matters
The trial suggests that, for early and intermediate stage unresectable HCC, TAE may achieve outcomes comparable to DEM-TACE, including time to progression, without a detected difference in adverse events or hospital stay. These findings inform consideration of embolization approaches, while the trial’s population and endpoints define the scope of the evidence.
What to keep in mind
The trial enrolled 111 patients, and the abstract does not report longer-term follow-up beyond the stated outcomes.