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α ‐fetoprotein response predicts survival benefits of thalidomide in advanced hepatocellular carcinoma
Author(s) -
CHEN L.T.,
LIU T.W.,
CHAO Y.,
SHIAH H.S.,
CHANG J.Y.,
JUANG S.H.,
CHEN S.C.,
CHUANG T.R.,
CHIN Y.H.,
WHANGPENG J.
Publication year - 2005
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2005.02547.x
Subject(s) - medicine , hepatocellular carcinoma , hazard ratio , confidence interval , proportional hazards model , thalidomide , oncology , carcinoma , gastroenterology , multivariate analysis , radiography , surgery , multiple myeloma
Summary Background: Radiographic measurements do not always reflect the biological response of hepatocellular carcinoma to drug therapy. Aims: To evaluate the clinical implications of tumour marker ( α ‐fetoprotein) response in advanced hepatocellular carcinoma patients with thalidomide treatment. Patients and methods: Forty‐two advanced hepatocellular carcinoma patients with baseline α ‐fetoprotein levels above 200 ng/mL and thalidomide therapy were included. Serum α ‐fetoprotein levels were measured every 4 weeks. α ‐fetoprotein response was defined as a 50% or greater reduction of α ‐fetoprotein levels for 4 or more weeks during treatment. Radiographic response was assessed by World Health Organization criteria; survivals were estimated by Kaplan–Meier method and prognostic factors were assessed by Cox's proportional hazard model. Results: With intention‐to‐treat analysis, radiographic response and α ‐fetoprotein response were obtained in 7% (three of 42, 95% confidence interval: 0–15) and 24% (10 of 42, 95% CI: 10–38) of patients, respectively. All radiographic response was observed in α ‐fetoprotein responders. Multivariate analyses showed α ‐fetoprotein response was independent prognostic factor for both progression‐free survival (relative risk = 0.394, 95% CI: 0.189–0.820, P = 0.013) and overall survival (relative risk = 0.241, 95% CI: 0.096–0.606, P =0.003), whereas radiographic response was not. Conclusion: α ‐fetoprotein response can more accurately reflect the biological response of advanced hepatocellular carcinoma to thalidomide therapy than radiographic response.