Early Decreases in α-Fetoprotein and Des-γ-carboxy Prothrombin Predict the Antitumor Effects of Hepatic Transarterial Infusion Chemotherapy with Cisplatin (CDDP) Powder in Patients with Advanced Hepatocellular Carcinoma

Abstract

Objective We retrospectively investigated the relationship between the tumor response and serial changes in α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) during hepatic arterial infusion of a cisplatin powder formulation (CDDP powder) in patients with advanced hepatocellular carcinoma (HCC). Methods Seventy-six advanced HCC patients were analyzed. All HCC patients received high-concentration cisplatin (1.43 mg/mL) via the haptic artery at a dose of 65 mg/m 2 . AFP and DCP were measured at baseline and four to eight weeks after treatment, and the antitumor responses were evaluated according to the response evaluation criteria in solid tumours (RECIST) criteria after one or two courses of treatment. The patients were classified into two groups, a decreased group and a non-decreased group, according to the change in the serum levels of AFP and DCP at four to eight weeks compared to baseline. Results The response to treatment of the decreased group (n=16) and non-decreased group (n=60) was complete response/partial response/stable disease/progressive disease (CR/PR/SD/PD) in 4/4/5/3 and 1/11/8/40 patients, respectively. The response rate and disease control rate of the decreased group were significantly higher than those of the non-decreased group (p=0.016 and p<0.001, respectively). The median survival time (MST) of the decreased/non-decreased groups were 25.9/10.6 months, respectively. The cumulative survival rates for the decreased group were significantly higher than those of the non-decreased group (p=0.042). In the multivariate analysis, vascular invasion and the decreased group were significant factors that affected the therapeutic efficacy. Conclusion A decrease in the levels of AFP and DCP after the first treatment with CDDP powder is a good predictor for the antitumor effect and the prognosis.

Predictive value of PIVKA-II and AFP for the non-objective response of HBV-associated hepatocellular carcinoma after transarterial chemoembolization: a prospective study

“…Alpha-fetoprotein (AFP) and protein induced by vitamin K absence-II (PIVKA-II) are two serological markers with relatively high specificity for HCC and play a key role in the early screening of HCC and evaluation of HCC intervention [10][11][12][13][14][15][16], but few relevant studies examined the AFP and PIVKA-II expression levels and how well they can predict non-objective response after TACE. Hence, this study aimed to investigate the AFP and PIVKA-II levels in patients with HBV-related HCC after TACE and to assess the predictive value of serum AFP and PIVKA-II for HCC non-objective response following TACE.…”

Severe Colitis Caused by Hepatic Arterial Infusion Chemotherapy with Cisplatin for Hepatocellular Carcinoma

“…Neutropenic enterocolitis, ischemic colitis, and pseudomembranous colitis are the specific types of colitis that are known complications of chemotherapy (3)(4)(5)(6)(7)(8). In Japan, a fine-powder formulation of cisplatin is commonly used to administer hepatic arterial infusion chemotherapy (HAIC) for transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC) (9,10). General chemotherapy with cisplatin may occasionally cause colitis (particularly neutropenic colitis) (6,8); however, no report has described colitis secondary to HAIC with cisplatin because the dosage of cisplatin used for HAIC is relatively small.…”