Failure of ketoconazole as anti-androgen therapy in nonresectable primary hepatocellular carcinoma

Lacking a treatment for nonresectable hepatocellular carcinoma (HCC), we have utilized the androgen antagonist properties of ketoconazole in treating eight patients, seven men and one woman, with HCC, which, in view of a higher prevalence of HCC in men, seems to be androgen dependent. Response to treatment was determined by grading symptoms, serum alphafetoprotein, alteration in tumor size, and duration of survival. No patient had any significant side-effects from ketoconazole. No symptomatic improvement occurred, percent tumor size increased from 38.6 +/- 12, mean +/- SEM, to 44.4 +/- 12, and mean survival in six patients who were followed until death was less than 8 weeks from diagnosis. Anti-androgenic therapy with ketoconazole was not effective in any of these patients.