Prospective study of chemoprevention of hepatocellular carcinoma with sho-saiko-to (TJ-9)

Abstract

Background. Most hepatocellular carcinomas (HCC) arise in patients with cirrhosis, in whom its incidence is high. The prevention of HCC in patients with cirrhosis is important. Methods. A prospective, randomized, nonblind controlled study was performed to evaluate the preventive effect of Sho‐saiko‐to (TJ‐9) on HCC development. TJ‐9 is a Chinese herbal medicine that contains crude extracts of seven herbs; it has anti tumor effects in experimental animals. Two hundred sixty patients with cirrhosis were randomly assigned to two groups, matched for age, sex, presence of hepatitis B surface antigen, and the severity of liver damage. The patients in the trial group were given TJ‐9 at a daily oral dose of 7.5 g in addition to the conventional drugs given to the control patients. The patients were prospectively monitored for 60 months and the cumulative incidence of HCC and the survival rate in the two groups were calculated. Results. The cumulative incidence curve for 5 years of the trial group was lower than that of the control group (P = 0.071). For the patients without HBs antigen, the difference was significant (P = 0.024). The survival curve for 5 years of the trial group was higher than that of the control group (P = 0.053). For the patients without HBs antigen, the difference was significant (P = 0.043). Conclusions. TJ‐9 helped to prevent the development of HCC in patients with cirrhosis, particularly in patients without HBs antigen.

Peroxisome proliferator-activated receptor γ ligand-induced growth inhibition of human hepatocellular carcinoma

“…Hepatocellular carcinoma is one of the most lethal malignancies where chemoprevention is recommended and different type newer agents are already tried on human subjects (Oka et al, 1995;Muto et al, 1996;Jacobson et al, 1997). PPARγ ligands exhibited a marked growth inhibitory potential on hepatocellular carcinoma cells through induction of G1 cell cycle arrest and recent studies have also shown that activation of PPARγ can inhibit the profibrogenic and proinflammatory actions of hepatic stellate cells (Galli et al, 2000;Marra et al, 2000;Miyahara et al, 2000).…”

Preventive Effects of a Kampo Medicine, Shosaikoto, on Inflammatory Responses in LPS-Treated Human Gingival Fibroblasts

“…7) And, TJ-9 induces apoptosis of a human hepatocellular carcinoma cell line and a cholangiocarcinoma cell line, 8) and prevents the development of hepatocellular carcinoma. 9) Considering these reports, we assumed that TJ-9 has an ability to suppress gingival inflammation in periodontal disease.…”

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

“…A later prospective, randomized (albeit nonblind) study by Oka et al [410] could elucidate the use of TJ-9 in preventing the development of HCC in patients with cirrhosis, particularly in patients without HBsAg. Successive studies continued to confirm that TJ-9 could protect experimental liver injury caused by D-galactosamine and liver fibrosis by inhibition of lipid peroxide formation in liver cells [411,412].…”