Modified cisplatin/interferon α‐2b/doxorubicin/5‐fluorouracil (PIAF) chemotherapy in patients with no hepatitis or cirrhosis is associated with improved response rate, resectability, and survival of initially unresectable hepatocellular carcinoma. Issue 18 (2nd July 2013)

• Record Type: Journal Article
• Authors: Kaseb, Ahmed O.; Shindoh, Junichi; Patt, Yehuda Z.; Roses, Robert E.; Zimmitti, Giuseppe; Lozano, Richard D.; Hassan, Manal M.; Hassabo, Hesham M.; Curley, Steven A.; Aloia, Thomas A.; Abbruzzese, James L.; Vauthey, Jean‐Nicolas
• Is Part Of: Cancer. Volume 119:Issue 18(2013)
• Page Start: 3334
• Page End: 3342
• Publication Date: 2013-07-02
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28209
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28209-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The purpose of this study was to evaluate the factors associated with response rate, resectability, and survival after cisplatin/interferon α‐2b/doxorubicin/5‐fluorouracil (PIAF) combination therapy in patients with initially unresectable hepatocellular carcinoma.</p> </sec> <sec id="cncr28209-sec-0002" sec-type="section"> <title>METHODS</title> <p>The study included 2 groups of patients treated with conventional high‐dose PIAF (n = 84) between 1994 and 2003 and those without hepatitis or cirrhosis treated with modified PIAF (n = 33) between 2003 and 2012. Tolerance of chemotherapy, best radiographic response, rate of conversion to curative surgery, and overall survival were analyzed and compared between the 2 groups, and multivariate and logistic regression analyses were applied to identify predictors of response and survival.</p> </sec> <sec id="cncr28209-sec-0003" sec-type="section"> <title>RESULTS</title> <p>The modified PIAF group had a higher median number of PIAF cycles (4 versus 2, <italic>P</italic> = .049), higher objective response rate (36% versus 15%, <italic>P</italic> = .013), higher rate of conversion to curative surgery (33% versus 10%, <italic>P</italic> = .004), and longer median overall survival (21.3 versus 10.6 months, <italic>P</italic> = .002). Multivariate analyses confirmed that positive hepatitis B serology (hazard ratio [HR] = 1.68; 95% confidence interval [CI] = 1.08‐2.59) and Eastern Cooperative Oncology Group performance status ≥ 2 (HR = 1.75; 95% CI = 1.04‐2.93) were associated with worse survival whereas curative surgical resection after PIAF treatment (HR = 0.15; 95% CI = 0.07‐0.35) was associated with improved survival.</p> </sec> <sec id="cncr28209-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>In patients with initially unresectable hepatocellular carcinoma, the modified PIAF regimen in patients with no hepatitis or cirrhosis is associated with improved response, resectability, and survival. <bold><italic>Cancer</italic> 2013;119:3334–42</bold> © <italic>2013 American Cancer Society</italic>.</p> </sec> </abstract>