Chronic thalidomide and chemoembolization for hepatocellular carcinoma.

Area of Science:

• Hepatobiliary Medicine
• Oncology
• Interventional Radiology

Background:

• Transcatheter arterial chemoembolization (TACE) is a standard treatment for hepatocellular carcinoma (HCC).
• Evaluating novel therapeutic combinations is crucial for advanced HCC management.

Purpose of the Study:

• To assess the efficacy and toxicity of thalidomide in combination with TACE for advanced HCC.
• To determine the safety profile and response rates of this combined therapy.

Main Methods:

• A phase I clinical trial involving 56 patients with unresectable HCC.
• Thalidomide dosage escalated from 200 mg/day up to 1,000 mg/day.
• TACE performed 4 weeks after thalidomide initiation, with repeated procedures as necessary.

Main Results:

• An overall response rate of 27.7% (complete and partial responses).
• Median progression-free survival of 7 months and overall survival of 21 months.
• Common side effects included fatigue, constipation, and nausea; Grade 3-4 toxicities involved elevated liver enzymes.

Conclusions:

• Thalidomide and TACE combination therapy is associated with significant non-hematologic side effects.
• The observed therapeutic benefit was not substantial enough to warrant further investigation for HCC.
• This combination is unlikely to be a viable treatment option for hepatocellular carcinoma.