Effect and Safety of Interferon for Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Abstract

BackgroundThe effect of interferon(IFN) in the management of hepatocellular carcinoma (HCC) remains controversial, and no clear recommendations have been proposed.ObjectivesTo evaluate the effect and safety of IFN for HCC.MethodsPubMed, OvidSP, and Cochrane Library were searched from their establishment date until August 30, 2012. Studies that met the inclusion criteria were systematically evaluated and then subjected to meta-analysis.ResultsThirteen randomized control trials (RCTs) involving 1344 patients were eligible for this study. When IFN was used as an adjuvant therapy for HCC patients after curative therapy, the meta-analysis showed that IFN reduced the 1-, 2-, 3-, 4-, and 5-year recurrence rates. Subgroup analysis showed that IFN reduced the 2-, 3-, 4-, and 5-year recurrence rates of hepatitis C viral (HCV)-related HCC. The effect of IFN for on hepatitis B virus(HBV)-related HCC patients could not be determined because of isufficient data. After surgical resection, adjuvant IFN therapy reduced the 4- and 5- recurrence rates. All studies reported that IFN could not improve the overall survival of HCV-realated HCC patients after curative therapies. Only one study showed that IFN was associated with better overall survival in HCC patients after curative therapy and subgroup of HCC patients after surgical resection. Thus, meta-analysis was not performed. Different treatment options were used as control to study the effect of IFN for intermediate and advanced HCC patients, thus meta-analysis was not appropriate. All included studies, except for one, reported that IFN treatment was well tolerated.ConclusionsAfter curative therapies, adjuvant IFN reduced the recurrence of HCC. IFN did not improve the survival of HCV-related HCC patients after curative therapy. Whether IFN is effective for intermediate and advanced HCC patients could not be determined because of insufficient data. The toxicity of IFN was acceptable.

Management of hepatocellular carcinoma: an overview of major findings from meta-analyses

“…Nineteen meta-analyses compared the outcomes of antiviral therapy versus no antiviral therapy (Supplementary Table S2) [10, 49, 54, 56, 58, 84–86, 103, 105, 107, 112, 120, 128, 139, 142, 154, 158–159]. Thirteen of them favored the use of antiviral therapy in term of OS [10, 49, 54, 84, 86, 105, 107, 112, 120, 128, 139, 142, 154]; one found that the use of antiviral therapy significantly improved the 5-year survival in HCV patients, but not HBV patients [58]; one demonstrated that the 1-year survival was statistically similar between the two groups [56]; one showed that 1-, 2-, 3-, 4-, and 5-year survival were statistically similar between the two groups [159]; another three did not report the survival data [85, 103, 158].…”

Summary of bi-shRNA^furin/GM-CSF Augmented Autologous Tumor Cell Immunotherapy (FANG™) in Advanced Cancer of the Liver

“…Clinical testing suggestive of positive activity has involved the use of adaptive transfer of lymphocytes, autologous tumor-pulsed dendritic cells (DCs) and alpha-fetoprotein (AFP) -pulsed DCs, but no significant tumor regression or survival response has been observed [17]. The use of interferon remains controversial insofar as clinical trials demonstrated reduced recurrence rates but without overall survival effect even when used in the adjuvant setting [18]. …”

Ribavirin suppresses hepatic lipogenesis through inosine monophosphate dehydrogenase inhibition: Involvement of adenosine monophosphate‐activated protein kinase‐related kinases and retinoid X receptor α

“…Therefore, it might be possible that tumors will develop in the future even after HCV elimination when only a DAA regimen is used. Much like the reports demonstrating that IFN treatment has the ability to suppress the growth of hepatocellular carcinoma,45, 46 our new finding that RBV has the ability to suppress lipogenesis in hepatic cells will shed light once again on the beneficial abilities of RBV not only for antiviral but also antipathogenic treatments of liver diseases, such as hepatic steatosis or hepatocellular carcinoma, in which aberrant lipogenesis is involved.…”