Clinical

Interferon/5-FU combination therapy may improve survival of liver cancer

Last Updated: 2006-05-25 15:10:18 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Treatment with systemic interferon-alpha and intraarterial 5-fluorouracil (5-FU) may improve the survival of patients with advanced hepatocellular carcinoma with portal venous invasion, according to a report in the May 1st issue of Cancer.

Hepatocellular carcinoma with portal venous invasion is associated with a median survival period of 3 months and seldom do any patients live beyond 1 year. Findings from small pilot studies have suggested improved outcomes with interferon/5-FU combination therapy.

To clarify the benefits of this combined treatment, Dr. Shuntaro Obi, from Kyoundo Hospital in Tokyo, and colleagues compared the outcomes of 116 patients treated with this approach to those of 40 historical controls who received other therapies.

Interferon-alpha was given intramuscularly at a dose of 5 million U on days 1, 3, and 5 of each treatment week. 5-FU was injected into the hepatic artery at a dose of 500 mg on days 1 though 5 of the first and second week of each 4-week cycle. The control subjects included 8 treated with radiotherapy, 6 treated with intraarterial epirubicin, and 26 who received supportive care only.

Nineteen patients experienced a complete response and 42 had a partial response, the report indicates. Nausea and appetite loss were the only apparent adverse effects.

Patients treated with the interferon/5-FU combination had 12- and 24-month survival rates of 34% and 18%, respectively. The corresponding rates in the control group were just 15% and 5%.

Twelve and 24-month survival rates for patients with a complete response to combination therapy were 81% and 59%, respectively. For partial responders, the rates were 43% and 18%.

"The combination therapy with 5-FU and interferon was safe, and substantially improved the survival rate among the complete responders. These results provide a rationale for future randomized controlled trials," the authors state.

Cancer 2006;106:1990-1997.