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Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
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Min Deng1,2 
, Shaohua Li1,2 , Wei Wei1,2 , Rongping Guo1,2
Correspondence to: Rongping Guo
ORCID https://orcid.org/0000-0003-2799-3463
E-mail guorp@sysucc.org.cn
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Gut Liver 2023;17(2):339-340. https://doi.org/10.5009/gnl220249
Published online February 15, 2023, Published date March 15, 2023
Copyright © Gut and Liver.
We read with great interest the recent research by Ahn
HAIC has been reported to have not only satisfactory efficacy in advanced liver cancer, including HCC and intrahepatic cholangiocarcinoma, but also a survival benefit for patients who received hepatectomy.2-4 Although the overall survival of the HAIC-based and sorafenib-based groups in this study was not significantly different, which may be due to the relatively small sample size, it can be seen from the trend of the survival curve that HAIC has a better prognosis.
I would like to raise a few questions to the authors of this study. First, the article mentioned HAIC and sorafenib combination therapies, but the specific combination information was not provided, such as the presence or absence of transarterial chemoembolization or immunotherapy. In recent years, immunotherapy has achieved satisfactory efficacy in many cancers, including HCC, and plays a critical role in systemic therapy.5-7 For instance, atezolizumab plus bevacizumab has been used as a first-line systemic strategy for treating advanced HCC.8 Moreover, one study has reported that HAIC combined with anti-PD-1 immunotherapy can improve the efficacy of HAIC, which is better than monotherapy.9
Second, this article reported that the proportion of adverse events following HAIC was high, and many cases were in grades 3 and 4. At baseline, 29% of patients had Child-Pugh class B before HAIC, and there was a lack of assessment of liver cirrhosis. It has been confirmed that patients treated with HAIC should have good performance status and reserved liver function.10 It is recommended that patients should be in Child-Pugh class A, or after liver protection, that the liver function is restored to Child-Pugh class A, and performance status ≤2.11
Third, the protocol of HAIC in this research is cisplatin and 5-flurouracil, which was infused via the chemoport. Studies have reported that FOLFOX (folinic acid, 5-fluorouracil, and oxaliplatin) HAIC has an apparent curative efficacy.12,13 The above studies reported that any implanted port system was not applied for FOLFOX HAIC. The catheter was removed when HAIC was completed. The HAIC regimen comprised oxaliplatin (135 mg/m2 from hour 0 to 3 on day 1), leucovorin (400 mg/m2 from hour 3 to 4.5 on day 1), fluorouracil (400 mg/m2 from hour 4.5 to 6.5 on day 1), and fluorouracil (2,400 mg/m2 over 46 hours from day 1 to day 3). HAIC was performed once every 3 to 4 weeks and repetitive catheterization was performed in the next cycle.3,12 Your team can consider this regimen in future clinical research or treatment.
Therefore, HAIC has good therapeutic prospects, and further studies with large-scale and more detailed clinical information are needed to assess the efficacy of HAIC.
No potential conflict of interest relevant to this article was reported.
Gut and Liver 2023; 17(2): 339-340
Published online March 15, 2023 https://doi.org/10.5009/gnl220249
Copyright © Gut and Liver.
Min Deng1,2 , Shaohua Li1,2 , Wei Wei1,2 , Rongping Guo1,2
1Department of Liver Surgery, Sun Yat-sen University Cancer Center, and 2State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
Correspondence to:Rongping Guo
ORCID https://orcid.org/0000-0003-2799-3463
E-mail guorp@sysucc.org.cn
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
We read with great interest the recent research by Ahn
HAIC has been reported to have not only satisfactory efficacy in advanced liver cancer, including HCC and intrahepatic cholangiocarcinoma, but also a survival benefit for patients who received hepatectomy.2-4 Although the overall survival of the HAIC-based and sorafenib-based groups in this study was not significantly different, which may be due to the relatively small sample size, it can be seen from the trend of the survival curve that HAIC has a better prognosis.
I would like to raise a few questions to the authors of this study. First, the article mentioned HAIC and sorafenib combination therapies, but the specific combination information was not provided, such as the presence or absence of transarterial chemoembolization or immunotherapy. In recent years, immunotherapy has achieved satisfactory efficacy in many cancers, including HCC, and plays a critical role in systemic therapy.5-7 For instance, atezolizumab plus bevacizumab has been used as a first-line systemic strategy for treating advanced HCC.8 Moreover, one study has reported that HAIC combined with anti-PD-1 immunotherapy can improve the efficacy of HAIC, which is better than monotherapy.9
Second, this article reported that the proportion of adverse events following HAIC was high, and many cases were in grades 3 and 4. At baseline, 29% of patients had Child-Pugh class B before HAIC, and there was a lack of assessment of liver cirrhosis. It has been confirmed that patients treated with HAIC should have good performance status and reserved liver function.10 It is recommended that patients should be in Child-Pugh class A, or after liver protection, that the liver function is restored to Child-Pugh class A, and performance status ≤2.11
Third, the protocol of HAIC in this research is cisplatin and 5-flurouracil, which was infused via the chemoport. Studies have reported that FOLFOX (folinic acid, 5-fluorouracil, and oxaliplatin) HAIC has an apparent curative efficacy.12,13 The above studies reported that any implanted port system was not applied for FOLFOX HAIC. The catheter was removed when HAIC was completed. The HAIC regimen comprised oxaliplatin (135 mg/m2 from hour 0 to 3 on day 1), leucovorin (400 mg/m2 from hour 3 to 4.5 on day 1), fluorouracil (400 mg/m2 from hour 4.5 to 6.5 on day 1), and fluorouracil (2,400 mg/m2 over 46 hours from day 1 to day 3). HAIC was performed once every 3 to 4 weeks and repetitive catheterization was performed in the next cycle.3,12 Your team can consider this regimen in future clinical research or treatment.
Therefore, HAIC has good therapeutic prospects, and further studies with large-scale and more detailed clinical information are needed to assess the efficacy of HAIC.
No potential conflict of interest relevant to this article was reported.
pISSN 1976-2283
eISSN 2005-1212
Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut atnd Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. +MORE
| Yong Chan Lee |
Professor of Medicine Director, Gastrointestinal Research Laboratory Veterans Affairs Medical Center, Univ. California San Francisco San Francisco, USA |
| Jong Pil Im | Seoul National University College of Medicine, Seoul, Korea |
| Robert S. Bresalier | University of Texas M. D. Anderson Cancer Center, Houston, USA |
| Steven H. Itzkowitz | Mount Sinai Medical Center, NY, USA |
All papers submitted to Gut and Liver are reviewed by the editorial team before being sent out for an external peer review to rule out papers that have low priority, insufficient originality, scientific flaws, or the absence of a message of importance to the readers of the Journal. A decision about these papers will usually be made within two or three weeks.
The remaining articles are usually sent to two reviewers. It would be very helpful if you could suggest a selection of reviewers and include their contact details. We may not always use the reviewers you recommend, but suggesting reviewers will make our reviewer database much richer; in the end, everyone will benefit. We reserve the right to return manuscripts in which no reviewers are suggested.
The final responsibility for the decision to accept or reject lies with the editors. In many cases, papers may be rejected despite favorable reviews because of editorial policy or a lack of space. The editor retains the right to determine publication priorities, the style of the paper, and to request, if necessary, that the material submitted be shortened for publication.
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