Feasibility and efficacy of hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma after sorafenib

• Published in: Hepatology research Vol. 44; no. 12; pp. 1179 - 1185
• Main Authors: Terashima, Takeshi, Yamashita, Tatsuya, Arai, Kuniaki, Sunagozaka, Hajime, Kitahara, Masaaki, Nakagawa, Hidetoshi, Kagaya, Takashi, Mizukoshi, Eishiro, Honda, Masao, Kaneko, Shuichi
• Format: Journal Article
• Language: English
• Published: Netherlands Blackwell Publishing Ltd 01.11.2014
• Subjects: hepatic arterial infusion chemotherapy; hepatocellular carcinoma; sorafenib; sorafenib; hepatic arterial infusion chemotherapy; hepatocellular carcinoma
• ISSN: 1386-6346; 1872-034X
• DOI: 10.1111/hepr.12266

Aim Sorafenib is the standard treatment for advanced hepatocellular carcinoma (HCC). However, although there is no proven therapeutic procedure following the termination of sorafenib, hepatic arterial infusion chemotherapy (HAIC) may be a treatment option in advanced HCC. The aim of this study was to evaluate feasibility and efficacy of HAIC for patients with advanced HCC as subsequent therapy. Methods We retrospectively evaluated 27 consecutive patients with advanced HCC who were treated with HAIC following sorafenib between June 2009 and December 2012 at our hospital. Cisplatin (20 mg/m2 per day) was administered via the hepatic artery for 10 min, prior to the continuous administration of 5‐fluorouracil (330 mg/m2 per day) over 24 h from days 1–5 and 8–12 and the s.c. administration of pegylated interferon α‐2b (1 μg/kg) on days 1, 8, 15, and 22. A treatment cycle consisted of 28 days of drug administration followed by 14 days of rest. Results The toxicity profile showed that hematological toxicities were common, and grade 3/4 neutropenia and thrombocytopenia were observed (51.9% and 48.1%, respectively). Five patients (18.5%) experienced device‐related complications. No unexpected adverse reactions and no treatment‐related deaths were observed. Partial response was obtained in eight patients (29.6%), and stable disease was noted in nine patients (33.3%). Median progression‐free survival and median survival time from initiation of HAIC were 4.0 and 7.6 months, respectively. Conclusions Because HAIC was well tolerated and exhibited moderate antitumor activity, it is a potentially useful treatment procedure in patients with advanced HCC even after failure of sorafenib.