Efficacy of capecitabine and oxaliplatin regimen for extrahepatic metastasis of hepatocellular carcinoma following local treatments

He, Sheng Li; Shen, Jie; Sun, Xian; Zhu, Xinen; Liu, Lu Ming; Dong, Jingcheng

doi:10.3748/wjg.v19.i28.4552

Cited by 10 publications

(15 citation statements)

References 30 publications

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“…Previous cohort studies, addressing the role of conventional therapy with capecitabine (alone or in combination regimens), as first-or second-line systemic therapy for advanced HCC, have demonstrated a certain anti-tumor efficacy and low toxicity (Patt et al 2004;Lee et al 2009;He et al 2013). A phase 2 trial, randomly assigning patients to sorafenib or capecitabine, showed a longer overall and progression-free survival of sorafenib patients but an imbalance of C-P class distribution and extrahepatic tumor spread between groups affect the reliability of results (Abdel-Rahman et al 2013).…”

Section: Discussionmentioning

confidence: 99%

“…Capecitabine, a prodrug of 5-fluorouracil (5-FU) metabolized to the active drug preferentially in liver and tumor tissue by thymidine phosphorylase (Walko and Lindley 2005), has been tested as first-and second-line treatment for HCC by some studies, using either the conventional or metronomic approach (Patt et al 2004;Lee et al 2009;Farrag 2012;He et al 2013;Abdel-Rahman et al 2013;Brandi et al 2013;Granito et al 2015;Murer et al 2016;Casadei Gardini et al 2017). The obtained results are sparse and rather conflicting, and only one of these studies compared capecitabine with best supportive care (BSC) in the setting of second-line therapy (Casadei Gardini et al 2017).…”

Section: Introductionmentioning

confidence: 99%

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Metronomic capecitabine as second-line treatment for hepatocellular carcinoma after sorafenib discontinuation

Trevisani

Brandi

Garuti

et al. 2017

J Cancer Res Clin Oncol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Metronomic capecitabine as second-line treatment for hepatocellular carcinoma after sorafenib discontinuation

Trevisani

Brandi

Garuti

et al. 2017

J Cancer Res Clin Oncol

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“…Patients in 9 studies did not receive any systemic chemotherapy, [ 12 – 20 ] whereas 20.65% patients had completed systemic chemotherapy before 4 weeks in 1 study. [ 6 ] The chemotherapy regimens included FOLFOX4, [ 6 ] GEMOX alone, [ 15 , 19 ] or in combination with cetuximab, [ 12 ] bevacizumab, [ 18 ] sorafenib, [ 20 ] XELOX, [ 13 , 14 ] or in combination with bevacizumab, [ 16 ] or oxaliplatin plus doxorubicin. [ 17 ] The patients continued sorafenib as maintenance therapy after receiving treatment with GEMOX plus sorafenib in 1 study.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of the oxaliplatin-based chemotherapy in the treatment of advanced primary hepatocellular carcinoma

et al. 2016

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Background:Many clinical studies have demonstrated the survival benefits of oxaliplatin-based chemotherapy for advanced hepatocellular carcinoma patients. Therefore, we aim to evaluate the efficacy and safety of oxaliplatin-based chemotherapy in patients with advanced hepatocellular carcinoma by conducting a meta-analysis of prospective studies.Methods:A comprehensive literature search was performed using the PubMed, Cochrane Library, EMBASE, and Web of Science databases from their inception to June 2016. Only prospective studies evaluating oxaliplatin-based chemotherapy in patients with advanced hepatocellular carcinoma were selected. The main outcomes included objective response rate (ORR), progression-free survival (PFS), overall survival (OS), and main adverse events.Results:Ten prospective studies involving 525 patients were included. The pooled ORR, 1-year PFS, and OS were 14.4% (95% confidence interval [CI] 9.2–19.6%), 9.3% (95%CI 10–28%), and 35.7% (95%CI 27–44%), respectively, for oxaliplatin-based chemotherapy. The median PFS and OS were 4.7 and 9.4 months, respectively. The incidences of grade 3/4 toxicities of neutropenia, thrombopenia, anemia, neurotoxicity, diarrhea, and nausea/vomiting were 17.2%, 9.2%, 6.0%, 4.8%, 3.1%, and 1.8%, respectively. Subgroup analysis revealed that the pooled ORR was 13.9% (95%CI 6.8–21%) in Asian patients and 12.8% (95%CI 6.8–18.7%) in Western patients. For Asian patients, the median PFS and OS were 4.2 and 9.2 months, and the 1-year PFS and OS were 12.5% and 30.5%, respectively. For Western patients, the median PFS and OS were 4.7 and 9.5 months, and the 1-year PFS and OS were 19.6% and 42.4%, respectively. There were no significant differences in the ORR, 1-year PFS, and OS (P > 0.05) between Asian and Western patients.Conclusions:Oxaliplatin-based chemotherapy appears to be effective and safe for the treatment of advanced hepatocellular carcinoma.

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“…However, these findings should be taken cautiously because of the heterogeneity and low quality of the evaluated studies 15 . Other chemotherapy protocols have been employed with some success in term of prolonged survival and in particular of different profile of toxicity 25 , 26 .…”

Section: Discussionmentioning

confidence: 99%

The role of metronomic capecitabine for treatment of recurrent hepatocellular carcinoma after liver transplantation

Ravaioli

Cucchetti

Pinna

et al. 2017

Sci Rep

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The management of recurrent hepatocellular carcinoma untreatable with surgical options is based on systemic therapy with sorafenib. Due to the high rates of adverse events connected to the therapy with sorafenib, metronomic capecitabine seems a promising strategy for these patients. We analyzed the data of 38 patients with hepatocellular carcinoma recurrent after liver transplantation performed at our center. We compared the outcome of 17 patients receiving metronomic capecitabine versus 20 patients experiencing best supportive care and versus the data of the literature about treatment with sorafenib. In the group treated with metronomic capecitabine we observed an increased survival after tumor recurrence at the univariate and multivariate analysis compared to the group of best supportive care (median 22 months vs. 7 months, p < 0.01). Data from the literature on the use of sorafenib showed outcomes like our study group, with similar patient and tumoral features. The episodes of acute rejection and the tumor stage at the recurrence showed a correlation with patient survival at the univariate analysis. The metronomic capecitabine for hepatocellular cancer recurrent after liver transplantation seems effective without important adverse events and comparable results to sorafenib.

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Efficacy of capecitabine and oxaliplatin regimen for extrahepatic metastasis of hepatocellular carcinoma following local treatments

Abstract: CapeOx showed modest anti-tumor activity in metastatic HCC. However, the manageable toxicity profile and the encouraging disease control rate deserve further study for these patients.

Cited by 10 publications

References 30 publications

Metronomic capecitabine as second-line treatment for hepatocellular carcinoma after sorafenib discontinuation

Metronomic capecitabine as second-line treatment for hepatocellular carcinoma after sorafenib discontinuation

Efficacy and safety of the oxaliplatin-based chemotherapy in the treatment of advanced primary hepatocellular carcinoma

The role of metronomic capecitabine for treatment of recurrent hepatocellular carcinoma after liver transplantation

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