Efficacy of Cyproheptadine Monotherapy in Hepatocellular Carcinoma With Bone Metastasis: A Case Report
Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses. A 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission...
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Published in | Frontiers in oncology Vol. 11; p. 620212 |
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Main Authors | , , , , , , |
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Language | English |
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Abstract | Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses.
A 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission after cyproheptadine monotherapy. Initially, her serum alpha fetal protein (AFP) level was high, reaching up to 17697.62 ng/ml. A dose of 4 mg cyproheptadine, 3 times a day for 17 months was prescribed as the only treatment. Within 3 months, the serum AFP level gradually normalized down to 4.3 ng/ml. Both liver biopsy and bone biopsies were subsequently performed after 2 weeks of cyproheptadine. The results showed no malignancy. During the 34 months of follow-ups, the serum AFP remained normal in the range of 1.05 to 2.86 ng/ml. The patient has survived for 5 years without back pain and sciatica thus far.
This is the first report to investigate a successful clinical approach in cyproheptadine monotherapy for an advanced HCC patient with bone metastasis. We recommend cyproheptadine as a potential anti-HCC agent for the treatment of HCC with bone metastasis, but more related studies such as prospectively clinical trials, and ideally randomized trials are still needed. |
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AbstractList | BackgroundHepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses.Case PresentationA 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission after cyproheptadine monotherapy. Initially, her serum alpha fetal protein (AFP) level was high, reaching up to 17697.62 ng/ml. A dose of 4 mg cyproheptadine, 3 times a day for 17 months was prescribed as the only treatment. Within 3 months, the serum AFP level gradually normalized down to 4.3 ng/ml. Both liver biopsy and bone biopsies were subsequently performed after 2 weeks of cyproheptadine. The results showed no malignancy. During the 34 months of follow-ups, the serum AFP remained normal in the range of 1.05 to 2.86 ng/ml. The patient has survived for 5 years without back pain and sciatica thus far.ConclusionsThis is the first report to investigate a successful clinical approach in cyproheptadine monotherapy for an advanced HCC patient with bone metastasis. We recommend cyproheptadine as a potential anti-HCC agent for the treatment of HCC with bone metastasis, but more related studies such as prospectively clinical trials, and ideally randomized trials are still needed. Background Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses. Case Presentation A 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission after cyproheptadine monotherapy. Initially, her serum alpha fetal protein (AFP) level was high, reaching up to 17697.62 ng/ml. A dose of 4 mg cyproheptadine, 3 times a day for 17 months was prescribed as the only treatment. Within 3 months, the serum AFP level gradually normalized down to 4.3 ng/ml. Both liver biopsy and bone biopsies were subsequently performed after 2 weeks of cyproheptadine. The results showed no malignancy. During the 34 months of follow-ups, the serum AFP remained normal in the range of 1.05 to 2.86 ng/ml. The patient has survived for 5 years without back pain and sciatica thus far. Conclusions This is the first report to investigate a successful clinical approach in cyproheptadine monotherapy for an advanced HCC patient with bone metastasis. We recommend cyproheptadine as a potential anti-HCC agent for the treatment of HCC with bone metastasis, but more related studies such as prospectively clinical trials, and ideally randomized trials are still needed. Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer prognoses. A 62-year-old woman with suspected advanced HCC accompanied by bone metastasis with severe back pain and sciatica showed disease remission after cyproheptadine monotherapy. Initially, her serum alpha fetal protein (AFP) level was high, reaching up to 17697.62 ng/ml. A dose of 4 mg cyproheptadine, 3 times a day for 17 months was prescribed as the only treatment. Within 3 months, the serum AFP level gradually normalized down to 4.3 ng/ml. Both liver biopsy and bone biopsies were subsequently performed after 2 weeks of cyproheptadine. The results showed no malignancy. During the 34 months of follow-ups, the serum AFP remained normal in the range of 1.05 to 2.86 ng/ml. The patient has survived for 5 years without back pain and sciatica thus far. This is the first report to investigate a successful clinical approach in cyproheptadine monotherapy for an advanced HCC patient with bone metastasis. We recommend cyproheptadine as a potential anti-HCC agent for the treatment of HCC with bone metastasis, but more related studies such as prospectively clinical trials, and ideally randomized trials are still needed. |
Author | Chen, Tsung-Hsien Hsieh, Ming-Chih Chou, Chu-Kuang Feng, Yu-Min Chen, Chi-Yi Berman, Dara Liao, Kai-Sheng |
AuthorAffiliation | 2 Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan 7 Department of Radiology, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan 3 Charles H. Dyson School of Applied Economics and Management, SC Johnson College of Business, Cornell University , Ithaca, NY , United States 1 Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan 6 Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan 4 Clinical Trial Center, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan 5 Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management , Chiayi , Taiwan |
AuthorAffiliation_xml | – name: 5 Department of Nursing, Chung-Jen Junior College of Nursing, Health Sciences and Management , Chiayi , Taiwan – name: 6 Department of Pathology, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan – name: 2 Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan – name: 7 Department of Radiology, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan – name: 3 Charles H. Dyson School of Applied Economics and Management, SC Johnson College of Business, Cornell University , Ithaca, NY , United States – name: 4 Clinical Trial Center, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan – name: 1 Divisions of Gastroenterology and Hepatology, Department of Internal Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital , Chiayi , Taiwan |
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Copyright | Copyright © 2021 Feng, Chen, Berman, Chou, Liao, Hsieh and Chen. Copyright © 2021 Feng, Chen, Berman, Chou, Liao, Hsieh and Chen 2021 Feng, Chen, Berman, Chou, Liao, Hsieh and Chen |
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Keywords | case report alpha fetal protein cyproheptadine hepatocellular carcinoma monotherapy |
Language | English |
License | Copyright © 2021 Feng, Chen, Berman, Chou, Liao, Hsieh and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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Notes | Edited by: Giuseppe Giaccone, Cornell University, United States This article was submitted to Pharmacology of Anti-Cancer Drugs, a section of the journal Frontiers in Oncology Reviewed by: Szu-Yuan Wu, Asia University, Taiwan; Chul Kim, Georgetown University, United States |
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Snippet | Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have poorer... Background Hepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have... BackgroundHepatocellular carcinoma (HCC) is one of the most common causes of cancer-related deaths worldwide. Particularly, cases of bone metastasis have... |
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SubjectTerms | alpha fetal protein case report cyproheptadine hepatocellular carcinoma monotherapy Oncology |
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Title | Efficacy of Cyproheptadine Monotherapy in Hepatocellular Carcinoma With Bone Metastasis: A Case Report |
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