Hormonal therapy for hepatocellular carcinoma.

Area of Science:

• Oncology
• Endocrinology
• Hepatology

Background:

• Hepatocellular carcinoma (HCC) is a leading cause of cancer death globally and in Taiwan, with poor patient survival rates due to limited effective treatments.
• Current treatments like chemotherapy and radiation therapy are often unsatisfactory, and surgery is only effective for early-stage, resectable tumors.
• Elevated glucocorticoid receptor (GR) levels and mRNA correlate with increased alpha-fetoprotein (AFP) in HCC patients, suggesting a role in tumor progression.

Purpose of the Study:

• To investigate the potential of hormonal therapy for hepatocellular carcinoma (HCC).
• To explore the role of steroid hormones in regulating HCC growth.
• To examine the relationship between glucocorticoid receptors, alpha-fetoprotein, and HCC progression.

Main Methods:

• Comparative analysis of glucocorticoid receptor (GR) and mRNA levels in HCC tissue versus adjacent liver tissue.
• Observation of progesterone's effect on alpha-fetoprotein (AFP) expression in hepatoma cells.
• Clinical observation of progesterone treatment outcomes in HCC patients.

Main Results:

• Significantly higher GR and mRNA levels were observed in HCC tissues compared to normal liver tissues.
• Elevated GR levels correlated with higher serum AFP levels in HCC patients.
• Progesterone demonstrated inhibitory effects on AFP expression in hepatoma cells and showed promising responses in a small cohort of HCC patients.

Conclusions:

• The expression of alpha-fetoprotein in proliferating HCC cells may be regulated by the glucocorticoid receptor complex.
• Steroid hormones or their antagonists could potentially modulate GR function in tumors, thereby regulating HCC growth.
• Hormonal therapy represents a promising avenue for future investigation and treatment of hepatocellular carcinoma.