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Fucoidan Improves Tumour Control and Liver Function in TACE for Unresectable Hepatocellular Carcinoma: A Randomised
Yanting Zou1,2,3, Szu-Yuan Wu4,5,6,7,8,9,10,11, Wanqin Zhang1,2,3
1Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China.
Background:
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. Transarterial chemoembolization (TACE) is the standard locoregional therapy for unresectable HCC but is limited by high recurrence and hepatic toxicity. Low-molecular-weight fucoidan (LMF), a sulfated polysaccharide from brown seaweed, has anticancer and hepatoprotective properties. This study assessed whether LMF enhances tumour response and preserves liver function when combined with TACE.
Methods:
In this randomised, double-blind, placebo-controlled trial, 82 patients with unresectable HCC were randomly assigned (1:1) to receive LMF (4.4 g twice daily) or placebo for 6 months in addition to TACE. Tumour response was assessed using modified RECIST criteria, and liver function was monitored via Child-Pugh classification. The primary endpoint was disease control rate (DCR), with objective response rate (ORR), liver function and adverse events as secondary endpoints.
Results:
Baseline characteristics were well balanced. DCR was significantly higher in the LMF group (95.24% vs. 80.00%, p = 0.035), with a lower progressive disease rate (4.76% vs. 20.00%). ORR was higher in the LMF group (52.38% vs. 35.00%) but not statistically significant (p = 0.1129). LMF preserved liver function (p = 0.029), with more patients maintaining Child-Pugh Class A (80.95% vs. 62.50%). Adverse event rates were similar, and no severe adverse events occurred.
Conclusions:
LMF improved tumour control, preserved liver function and had a favourable safety profile. These findings suggest LMF may mitigate TACE-related hepatic toxicity and prolong treatment eligibility, warranting further validation in larger trials.
