Transcatheter arterial embolization with zinostatin stimalamer for hepatocellular carcinoma.

Abstract

Zinostatin stimalamer (SMANCS) is a lipophilic intra-arterial chemotherapeutic agent for hepatocellular carcinoma (HCC). In our previous study, transcatheter arterial infusion chemotherapy using SMANCS for HCC showed a response rate of 20%. In an effort to obtain a superior anti-tumor effect against HCC, we conducted a phase II study of transcatheter arterial embolization (TAE) using SMANCS and gelatin sponge in 50 chemotherapy-naive patients with HCC. Four milligrams SMANCS plus 4 ml lipiodol emulsion was injected into the hepatic artery, followed by an injection of gelatin sponge. The responses were evaluated by computed tomography (CT) 1 month after treatment and thereafter every 3-4 months. One patient (2%) showed complete response and 15 patients (30%) had partial response resulting in an overall response rate of 32% (16/50; 95% confidence interval 19-45%). In 33 patients (66%), the disease remained stable, and 1 patient (2%) showed progressive disease. In 35 patients (70%), the rate of necrotic area to whole tumor was more than 50% according to the evaluation method using lipiodol accumulation in CT. The 1-, 3- and 5-year survival rates were 90, 55 and 19%, respectively. Grade 3 hematological toxicity was observed as thrombocytopenia in 2 patients (4%). Grade 3 and 4 non-hematological toxicity (liver dysfunction) occurred in 17 (34%) and 7 patients (14%), respectively. TAE using SMANCS, which was well tolerated, may be an effective treatment for advanced HCC.

• Authors: Takuji Okusaka, Shuichi Okada, Hideki Ueno, Masafumi Ikeda, Ryoko Iwata, Hiroyoshi Furukawa, Kenichi Takayasu, Noriyuki Moriyama, Tosiya Sato, Keiko Sato
• Journal: Oncology (Oncology) Vol. 62 Issue 3 Pg. 228-33 ( 2002) ISSN: 0030-2414 [Print] Switzerland
• PMID: 12065870 (Publication Type: Clinical Trial, Clinical Trial, Phase II, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: Copyright 2002 S. Karger AG, Basel

Chemical References

• Antineoplastic Agents
• Maleic Anhydrides
• Polystyrenes
• poly(maleic acid-styrene)neocarzinostatin
• Zinostatin

Topics

• Adult
• Aged
• Antineoplastic Agents (administration & dosage, adverse effects)
• Carcinoma, Hepatocellular (mortality, pathology, therapy)
• Chemoembolization, Therapeutic
• Female
• Humans
• Liver Neoplasms (mortality, pathology, therapy)
• Male
• Maleic Anhydrides (administration & dosage, adverse effects)
• Middle Aged
• Polystyrenes (administration & dosage, adverse effects)
• Survival Rate
• Treatment Outcome
• Zinostatin (administration & dosage, adverse effects, analogs & derivatives)