[FAIT (FU arterial infusion and interferon therapy) for hepatocellular carcinoma]

Area of Science:

• Hepatobiliary Oncology
• Interventional Radiology
• Cancer Immunology

Context:

• Advanced hepatocellular carcinoma (HCC) presents significant treatment challenges, particularly with portal venous tumour thrombi (PVTT).
• Current treatment options for advanced HCC with PVTT have limited efficacy.
• Understanding the mechanisms of novel therapies is crucial for improving patient outcomes.

Purpose:

• To evaluate the efficacy of FU Arterial Infusion and Interferon Therapy (FAIT) in patients with advanced HCC and PVTT.
• To investigate the synergistic mechanisms of action for FAIT, including its effects on cell cycle, apoptosis, and immune modulation.
• To compare survival outcomes of patients treated with FAIT alone versus FAIT combined with surgery.

Summary:

• FAIT demonstrated objective responses in 43.6% of advanced HCC patients with PVTT when used as monotherapy.
• In patients with HCC and PVTT, combining FAIT with surgery resulted in 100% 1-year survival, compared to 67% mortality within 1 year for those not receiving FAIT and surgery.
• FAIT exhibits synergistic effects of 5-FU and Interferon-alpha, influencing cell cycle progression (p27Kip1), inducing apoptosis (Bcl-xl reduction), and modulating the immune response (TRAIL/TRAIL-receptor pathway).

Impact:

• FAIT represents a promising therapeutic strategy for advanced HCC, especially in cases involving tumour thrombi in major portal branches.
• The findings support the potential of FAIT to improve survival rates and response in a challenging HCC patient subgroup.
• Elucidating the mechanistic basis of FAIT provides a foundation for further therapeutic development and optimization in HCC treatment.