AIM: To evaluate the clinical benefit of thalidomide in patients

AIM: To evaluate the clinical benefit of thalidomide in patients Axitinib with advanced hepatocellular carcinoma (hepatoma). alcoholism. Hepatoma was diagnosed with histology alpha-fetoprotein (aFP) > 400 ng/mL or image examination there were 30 33 and 36 cases respectively. At the time of thalidomide therapy more than 81% had cirrhotic status. Twenty-two patients were in group A (< 5000 mg) with median survival time about 25 days for 77 cases in group B (≥ 5000 mg) the median survival time was about 109 days. Six subjects had partial response. Most adverse effects were skin rush neuropathy somnolence and constipation. CONCLUSION: Several patients responded to thalidomide therapy. As a single drug therapy thalidomide might not have good therapeutic effect for all cases but a small ratio of patients had exciting response the resistance or tumor escape would Axitinib develop after long-term use. Up to now no defined facts could be used to predict response. The effect of thalidomide on hepatoma might be associated with the dosage. As salvage therapy thalidomide has its value. Combination or adjuvant therapy will be the next trial. INTRODUCTION Hepatocellular carcinoma (hepatoma) is usually a major cause of death in the world especially in the endemic areas of viral hepatitis B and C such as Taiwan China. Taiwan is usually a high prevalence area of hepatocellular carcinoma more than 6900 people died of hepatocellular carcinomas at Taiwan in 2002. Although the incidence rate of small hepatoma was increased in the last few years but most patients had severe liver cirrhosis that made them drop the opportunities to receive curative therapy. Therapy of hepatocellular carcinoma in chronic liver disease patients is challenging also. Local treatments such as surgical resection ethanol intratumor injection ablation with high frequency or transhepatic artery embolization have been improved but these procedure might cause new problems and the curative and survival rates of these patients are still low[1]. The average survival time is usually shorter than 6 months if metastasis occur. However to seek new effective therapy for hepatoma to prolong the patient life or improve their life quality with later stage of hepatoma are major issues at Taiwan. Anti-angiogenesis is usually a new concept for cancer therapy in the 1970’s Dr Folkman launched out the theory[2]. Neoplasm’s growth depends on angiogenesis angiogenesis inhibitors could block the process and treat neoplasm especially vascularized Axitinib ones. Many antiangiogenic brokers Axitinib are developed and some are going in clinical trials. Thalidomide is usually one of them and has been studied for its anti-angiogenic activity in last several years. Hepatoma is usually a hypervascular tumor that has been proved by angiography and histology. For this reason antiangiogenesis therapy may be effective for hepatoma. Up to now few papers described the antiangiogenesis therapy for hepatoma. The first success case of hepatoma treated with thalidomide was reported in 2000. A 67-year-old man had a 6 cm large tumor. Unfortunately the tumor continued to grow after 5FU and interferon therapy chemoembolization and chemotherapy. Thalidomide therapy was used. The tumor was shrunk aFP was diminished and the patient was alive in 2000[3]. Henceforward some might had exciting results some were disappointed Although a few patients would get benefit from thalidomide therapy[4-8]. No final conclusion was made. In this study we report our experience in using thalidomide as a salvage drug for the patients with hepatoma who were unsuitable for other managements. MATERIALS AND METHODS One hundred and six patients with hepatocellular carcinoma were entered into the study between RAC Mar 2000 and July 2002. A diagnosis of hepatoma was made by histopathology alpha fetoprotein (AFP) more than 400 ng/mL or image plus clinical manifestation. All of them were poor candidates for more aggressive treatment. Those patients were required to receive a risk-benefit counseling to sign an informed-consent agreement to use forms of birth control. The Institutional Ethics Committee of the Mackay Memorial Hospital and Department of Public Health in.