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Efficacy and safety of thalidomide in patients with hepatocellular carcinoma

Hsueh-Erh Chiou1, Tsang-En Wang, Ying-Yue Wang

  • 1Pharmacy Department, Mackay Memorial Hospital, Taipei 10449, Taiwan, China.

World Journal of Gastroenterology
|November 17, 2006
PubMed

Insights

Thalidomide treatment shows effectiveness in early-stage hepatocellular carcinoma (HCC), particularly in patients with cirrhosis or smaller tumors. Continued low-dose thalidomide (200 mg/d) may improve outcomes.

Area of Science:

  • Hepatology
  • Oncology
  • Pharmacology

Background:

  • Hepatocellular carcinoma (HCC) is a significant global health concern.
  • Identifying predictive factors for treatment response in HCC is crucial for patient management.
  • Thalidomide has emerged as a potential therapeutic agent for HCC.

Purpose of the Study:

  • To determine patient characteristics associated with a positive response to thalidomide treatment in HCC.
  • To identify predictors of thalidomide efficacy in hepatocellular carcinoma patients.

Main Methods:

  • Retrospective analysis of 42 HCC patients treated with thalidomide (200 mg/d) from July 2002 to July 2004.
  • Data collected included hepatitis history, comorbidities, alpha-fetoprotein levels, tumor volume, survival, and thalidomide dosage and side effects.
  • Patients were categorized into partial response/stable disease (PR + SD) and progressive disease (PD) groups.

Main Results:

  • Overall, 5% of patients achieved partial response and 21% had stable disease. Patients with cirrhosis (100% vs. 64.5%) and tumors smaller than 5 cm (63.6% vs. 25.8%) showed significantly higher response rates.
  • The PR + SD group received higher total thalidomide doses and had longer survival.
  • Comorbid conditions were associated with a higher incidence and number of adverse reactions to thalidomide.

Conclusions:

  • Thalidomide therapy is most effective in patients with early-stage, small HCC, especially those with comorbidities.
  • A low dose of 200 mg/d thalidomide, administered for a sufficient duration, is recommended for optimal efficacy.
  • Further research into predictive biomarkers for thalidomide response in HCC is warranted.
Abstract

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