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Systemic combination therapy of intravenous continuous 5-fluorouracil and subcutaneous pegylated interferon alfa-2a for advanced hepatocellular carcinoma

  • Uchino, Koji1
  • Obi, Shuntaro2
  • Tateishi, Ryosuke1
  • Sato, Shinpei2
  • Kanda, Miho2
  • Sato, Takahisa2
  • Arano, Toru1
  • Enooku, Kenichiro1
  • Goto, Eriko1
  • Masuzaki, Ryota1
  • Nakagawa, Hayato1
  • Asaoka, Yoshinari1
  • Kondo, Yuji1
  • Yamashiki, Noriyo1
  • Goto, Tadashi1
  • Shiina, Shuichiro1
  • Omata, Masao3
  • Yoshida, Haruhiko1
  • Koike, Kazuhiko1
  • 1 The University of Tokyo, Department of Gastroenterology, Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan , Tokyo (Japan)
  • 2 Kyoundo Hospital, Department of Gastroenterology and Hepatology, Tokyo, Japan , Tokyo (Japan)
  • 3 Yamanashi Prefectural Hospital Organization, Yamanashi, Japan , Yamanashi (Japan)
Published Article
Journal of Gastroenterology
Springer Japan
Publication Date
Mar 22, 2012
DOI: 10.1007/s00535-012-0574-3
Springer Nature


BackgroundIn Japan, sorafenib is now the first-line therapy for individuals with advanced hepatocellular carcinoma (HCC), but no other treatment is available for such patients. The aim of this study was to assess the efficacy and safety of combination therapy with systemic continuous intravenous infusion of 5-fluorouracil (5-FU) and subcutaneous peginterferon alfa-2a, which was used before sorafenib was introduced to Japan.MethodsTwo hundred and twenty-three HCC patients, who were not amenable to curative surgery, percutaneous ablation, or transarterial chemoembolization (TACE), and for whom intraarterial chemotherapy was not indicated because of the presence of extrahepatic metastasis or stenosis of the common hepatic artery, received peginterferon alfa-2a (90 μg subcutaneously on days 1, 8, 15, and 22) and 5-FU (500 mg/day intravenously given continuously on days 1–5 and 8–12). We assessed their response to treatment and survival, and treatment safety.ResultsThe response rate was 9.4 % (including six patients with complete response) and the disease-control rate was 32.7 %. The median time to progression was 2.0 months. The overall median survival time was 6.5 months (Child–Pugh class A: 9.2 months vs. Child–Pugh class B: 2.8 months). In a multivariate analysis, Eastern Cooperative Oncology Group (ECOG) performance status >0, Child–Pugh class B, and the presence of macroscopic vascular invasion were independent predictors of poor prognosis. The major grade 3–4 adverse events were leucopenia (13.9 %) and thrombocytopenia (5.8 %). No treatment-related deaths occurred.ConclusionsThis combination therapy was well tolerated and showed promising efficacy. Further studies are needed to establish the usefulness of this treatment.

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