Could thymostimulin prevent hepatocellular carcinoma occurrence in patients with liver cirrhosis?

On the basis of a possible pathogenetic role of immunodepression in the development of hepatocellular carcinoma in patients with chronic hepatitis B/C viral infection and liver cirrhosis, we treated 34 liver cirrhosis patients (M/F 24/10; age: 14 pts less than or equal to 60 years, 20>60; Performance status: 22 0-1, 12 2-3; Childs' grade: 21 A, 13 B; ascites yes/not: 4/30) employing thymostimulin (TST), at the dosage of 50 mg/m(2) i.m. 3 times a week, until death or severe toxicity occurrence. Etiology of cirrhosis was viral in all cases. The patients were followed up every 3 months by means of clinical examination and biochemical analyses; every 6 months by checking viral serum markers, alpha-fetoprotein and by means of ultrasounds. To date, 34 patients have been treated, with a median follow-up of 6 (1-8) years. No occurrence of hepatocellular carcinoma has been observed, with a statistically significant difference between observed and expected HCC (p<0.05). Thymostimulin treatment was well tolerated. Our data seem to suggest that the immunomodulating treatment could significantly reduce the risk of HCC occurrence in patients with liver cirrhosis.