Systemic Chemotherapy with Epirubicin for Treatment of Advanced or Multifocal Hepatocellular Carcinoma

Abstract

Background: The purpose of this retrospective study was to determine the response rate and effect on survival of chemotherapy with epirubicin in non-resectable advanced hepatocellular carcinoma (HCC). Methods: Fifty-two patients with non-resectable disease were treated with epirubicin. A treatment cycle consisted of 20 mg/m² i.v. on days 1, 8 and 15 and was repeated every 4 weeks to a maximum dose of 1,000 mg/m². Forty-four patients were eligible for analysis. Results: Out of 44 patients, 1 (2.3%) achieved a complete response, 3 (6.8%) had partial responses and 16 (36%) had stable disease (SD). For patients with successful disease control (complete and partial responders and patients with SD), the median survival was 16.2 months; for non-responders, it was 6.1 months (p < 0.003). Eight (88.9%) of 9 patients with alpha-fetoprotein (AFP) levels <50 µg/l achieved successful disease control compared to 12 (34.9%) out of 35 patients with initially elevated AFP (p < 0.0001). Conclusion: Epirubicin appears to be an active therapeutic option for patients with non-resectable HCC. Especially the subgroup of patients with low levels of AFP may benefit from this treatment.

A Phase II Study of Epirubicin and Thalidomide in Unresectable or Metastatic Hepatocellular Carcinoma

“…The experience with epirubicin in Hong Kong also suggests its limited activity in HCC, with a response rate of 9% [10]. A retrospective study with single-agent epirubicin, given at a dose of 20 mg/m 2 weekly for three consecutive weeks every 4 weeks, demonstrated a 9% response rate in HCC [11]. Studies in breast cancer have shown that the weekly schedule of epirubicin is a valid alternative and may have a better safety profile [12,13].…”

A novel cell cycle blocker extracted from Stellera chamaejasme L. inhibits the proliferation of hepatocarcinoma cells

“…Even though locoregional therapies such as hepatic artery ligation Tables I and II (samples were collected or embolization have been developed in the past decades, they have failed to significantly prolong the overall survival of liver cancer patients (22)(23)(24). Despite decades of efforts made by researchers worldwide, the investigation of anti-liver cancer drugs is stagnant (25)(26)(27)(28). Conventionally, the commonly used drugs for liver cancer chemotherapy are 5-fluorouracil, mitomycin C, cisplatin, doxorubicin and their derivatives.…”

Medical Management Options for Hepatocellular Carcinoma

“…Both epirubicin and mitoxantrone have an approximately similar level of antitumor efficacy as doxorubicin (response rates 10 to 25 percent) (Pohl et al,2001;Dunk et al,1985). In contrast, the single agent activity of pegylated liposomal doxorubicin (PLD) is limited (Lind et al, 2007).…”