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Wang F, Lv H, Li Y, Han T, Liu H, Jia K, Liu F, Gao Y, Wang F. Complete cure of a patient with HBV-associated hepatocellular carcinoma with lung metastasis using interferon and survival up to 108 months: A case report and literature review. Oncol Lett 2018; 16:2979-2988. [PMID: 30127887 PMCID: PMC6096095 DOI: 10.3892/ol.2018.9033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Accepted: 06/01/2018] [Indexed: 12/27/2022] Open
Abstract
Hepatocellular carcinoma (HCC) has a poor prognosis due to its asymptomatic onset and susceptibility to metastasis. The survival of patients with advanced HCC is 6-12 months. As a first-line medicine for the control of hepatitis B virus, interferon (IFN) is also capable of inhibiting tumor growth and modulating immunity. However, treatment of HCC with lung metastasis using IFN has been rarely reported. The present study reports the case of one patient with HCC having lung metastasis who underwent a one-time treatment with transcatheter arterial chemoembolization (TACE) and was subsequently completely cured by single peginterferon α 2a (PEG-IFNα2a); and has survived up to 108 months. A 53-year-old male patient diagnosed with HBV-related HCC with lung metastasis underwent TACE using floxuridine (FUDR) 500 mg, cisdiamine dichloroplatinum (CDDP) 20 mg, mitomycin 10 mg, and ultrafluid lipiodol 10 ml, together with local thoracic aorta chemotherapy using FUDR 250 mg and CDDP 20 mg. His metastatic lung cancer aggravated. However, after 9 months of treatment with subcutaneous injections of PEG-IFNα 2a once per week, the metastatic lung foci gradually shrunk until disappearance and the HCC lesion stabilized without progression. According to the World Health Organization criteria for the efficacy of solid tumors, this was a case of complete response. Upon follow-up up to 108 months his metastatic lung cancer had disappeared and HCC did not recur. Therefore, IFN intervention may be an appropriate novel adjuvant therapy for patients with HCC with lung metastasis and requires further attention and study.
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Affiliation(s)
- Fang Wang
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Hongmin Lv
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Yan Li
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Tao Han
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Hui Liu
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Kefeng Jia
- Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Fang Liu
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Yanying Gao
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
| | - Fengmei Wang
- Department of Gastroenterology and Hepatology, The Third Central Hospital of Tianjin, Hedong, Tianjin 300170, P.R. China.,Tianjin Institute of Hepatobiliary Disease, Hedong, Tianjin 300170, P.R. China.,Tianjin Key Laboratory of Artificial Cells, Hedong, Tianjin 300170, P.R. China.,Artificial Cell Engineering Technology Research Center of The Public Health Ministry, Hedong, Tianjin 300170, P.R. China
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2
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Nagano H, Obi S, Hatano E, Kaneko S, Kanai F, Omata M, Tsuji A, Itamoto T, Yamamoto K, Tanaka M, Kubo S, Hirata K, Nakamura H, Tomimaru Y, Yamanaka T, Kojima S, Monden M. Multicenter, randomized, controlled trial of S-1 monotherapy versus S-1 and interferon-α combination therapy for hepatocellular carcinoma with extrahepatic metastases. Hepatol Res 2018; 48:717-726. [PMID: 29377364 DOI: 10.1111/hepr.13067] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/20/2018] [Accepted: 01/24/2018] [Indexed: 02/08/2023]
Abstract
AIM No effective therapies for extrahepatic metastases from hepatocellular carcinoma (HCC) have yet been identified. Previous studies suggested a potentially promising antitumor effect of combination therapy of S-1, a novel oral dihydropyrimidine dehydrogenase inhibitor, and interferon (IFN)-α. The present study aimed to investigate the clinical efficacy of single agent S-1 and S-1/IFN-α for HCC patients with extrahepatic metastases in a randomized, open-label, multicenter trial. METHODS A total of 103 patients with HCC with extrahepatic metastases were randomly assigned to the S-1/IFN-α group, receiving the combination of S-1 and IFN-α, or the S-1 group, receiving the single agent of S-1. Clinical efficacy and adverse events were compared between the two groups. RESULTS A total of 49 patients in the S-1/IFN-α group and 51 patients in the S-1 group were included in the efficacy analysis. The response rate was 22.4% (11/49) in the S-1/IFN-α group and 13.7% (7/51) in the S-1 group; there was no significant difference. Overall and progression-free survival in the two groups were also not significantly different (1-year overall survival 50.8% vs. 72.4%, median progression-free survival 127 days vs. 157 days). The incidence of grade ≥3 adverse events in the S-1/IFN-α group was 62.7% (32/51), which tended to be higher than in the S-1 group (43.1% [22/51]). CONCLUSIONS Oncological outcomes in both treatment groups were favorable compared with previous reports, though there was no significant beneficial effect of adding IFN-α to S-1 for the treatment of HCC patients with extrahepatic metastases.
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Affiliation(s)
- Hiroaki Nagano
- Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan.,Department of Gastroenterological, Breast and Endocrine Surgery, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Shuntaro Obi
- Department of Gastroenterology and Hepatology, Kyoundo Hospital of the Sasaki Institute, Tokyo, Japan
| | - Etsuro Hatano
- Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shuichi Kaneko
- Department of Gastroenterology, Kanazawa University Hospital, Kanazawa, Japan
| | - Fumihiko Kanai
- Department of Gastroenterology, University of Tokyo, Tokyo, Japan
| | - Masao Omata
- Department of Gastroenterology, University of Tokyo, Tokyo, Japan
| | - Akihito Tsuji
- Department of Clinical Oncology, Kochi Health Science Center, Kochi, Japan
| | - Toshiyuki Itamoto
- Department of Surgery, Division of Frontier Medical Science, Programs for Biomedical Research, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan
| | - Kazuhide Yamamoto
- Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Masatoshi Tanaka
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Shoji Kubo
- Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Koichi Hirata
- Department of Surgery, Surgical Oncology & Science, Sapporo Medical University, Sapporo, Japan
| | - Hideji Nakamura
- Division of Hepatobiliary and Pancreatic Disease, Department of Internal Medicine, Hyogo College of Medicine, Nishinomiya, Japan
| | - Yoshito Tomimaru
- Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takeharu Yamanaka
- Department of Biostatistics, Yokohama City University School of Medicine, Yokohama, Japan
| | - Shinsuke Kojima
- Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan
| | - Morito Monden
- Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Japan
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3
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Okano Y, Kuramochi H, Nakajima G, Katagiri S, Yamamoto M. Elevated levels of mRNAs encoding dihydropyrimidine dehydrogenase and thymidylate synthase are associated with improved survival of patients with hepatocellular carcinoma treated with S-1. Oncol Lett 2017; 14:930-936. [PMID: 28693254 DOI: 10.3892/ol.2017.6241] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Accepted: 03/09/2017] [Indexed: 12/20/2022] Open
Abstract
Thymidylate synthase (TYMS) and dihydropyrimidine dehydrogenase (DPYD) are associated with the response of tumors to fluoropyrimidines. The aim of the present study was to investigate the association between the levels of TYMS and DPYD mRNAs and the efficacy of S-1 for treating patients with HCC. A total of 35 patients with HCC who received S-1 upon recurrence (S-1 group) and 20 patients who never received a fluoropyrimidine (control group) were studied. The levels of TYMS and DPYD mRNA in surgically resected specimens were determined using reverse transcription-polymerase chain reaction assays. Overall survival (OS) time of S-1 group patients with high levels of DPYD mRNA was significantly longer compared with that of patients with low levels (median 501 days vs. 225 days; P=0.016). Similarly, the OS time of those patients with high levels of TYMS mRNA was significantly longer compared with those with low levels (median 503 days vs. 239 days; P=0.0076). By contrast, there was no difference in OS time of the control group between patients with high and low levels of DPYD and TYMS mRNAs. The levels of TYMS and DPYD mRNAs may serve as predictive markers for patients with HCC who receive S-1 chemotherapy.
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Affiliation(s)
- Yusuke Okano
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shunjukuku, Tokyo 162-8666, Japan
| | - Hidekazu Kuramochi
- Department of Chemotherapy and Palliative Care, Tokyo Women's Medical University, Shunjukuku, Tokyo 162-8666, Japan.,Department of Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Chiba 276-8524, Japan
| | - Go Nakajima
- Department of Chemotherapy and Palliative Care, Tokyo Women's Medical University, Shunjukuku, Tokyo 162-8666, Japan
| | - Satoshi Katagiri
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shunjukuku, Tokyo 162-8666, Japan.,Department of Surgery, Tokyo Women's Medical University, Yachiyo Medical Center, Yachiyo, Chiba 276-8524, Japan
| | - Masakazu Yamamoto
- Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shunjukuku, Tokyo 162-8666, Japan
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4
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Kurahashi S, Sano T, Natsume S, Senda Y, Yamaura H, Inaba Y, Shimizu Y. Surgical treatment after hepatic arterial infusion chemotherapy for hepatocellular carcinoma extending into the right atrium. Surg Case Rep 2015; 1:47. [PMID: 26366344 PMCID: PMC4560137 DOI: 10.1186/s40792-015-0047-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/25/2015] [Indexed: 02/07/2023] Open
Abstract
A resected case of hepatocellular carcinoma which extended into the right atrium after treatment with hepatic arterial infusion chemotherapy (HAIC) is described. An 81-year-old man presented with right hypochondralgia. CT demonstrated a hypervascular tumor 11.5 cm in diameter extending into the right atrium through the right hepatic vein. The patient underwent HAIC with 100 mg of cisplatin (CDDP IA-call®) particles three times every month. The tumor showed a marked shrinkage and an involution of the venous thrombus around the orifice of the right hepatic vein. Right hemihepatectomy with tumor thrombectomy was performed as a salvage surgery using a total hepatic vascular exclusion technique. Histologically, the tumor turned into diffuse necrosis and fibrosis, so viable tumor cells were encountered neither in the main tumor nor venous thrombus. The therapeutic effect of HAIC was pathological complete remission. The patient has been doing well for 6 years after the surgery without evidence of tumor recurrence. The salvage operation was safely achievable for the initially unresectable advanced hepatocellular carcinoma extending into the right atrium.
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Affiliation(s)
- Shintaro Kurahashi
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
| | - Tsuyoshi Sano
- Department of Gastroenterological Surgery, Aichi Medical University Hospital, 1-1 Yazakokarimata, Nagakute, Aichi Japan
| | - Seiji Natsume
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
| | - Yoshiki Senda
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
| | - Hidekazu Yamaura
- Department of Interventional Radiology, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
| | - Yoshitaka Inaba
- Department of Interventional Radiology, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
| | - Yasuhiro Shimizu
- Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Kanokoden 1-1, Chikusa-ku, Nagoya, Aichi Japan
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5
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Clinical significance of surgical resection of metastatic lymph nodes from hepatocellular carcinoma. Surg Today 2014; 45:1112-20. [PMID: 25205550 DOI: 10.1007/s00595-014-1028-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 08/20/2014] [Indexed: 01/24/2023]
Abstract
PURPOSE The clinical significance of the surgical resection of metastatic lymph nodes (LN) from patients with hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to evaluate the significance of the surgical resection of LN metastasis of HCC. METHODS Among 961 patients who underwent surgical resection for HCC in our hospital, LN metastasis was identified in 38 patients. In these patients, the metastatic LN were removed completely in 22 patients (complete removal group), and incompletely or not removed in 16 patients (control group). The long-term prognosis after LN metastasis was compared between the two groups. RESULTS The overall survival rate after LN metastasis was significantly better in the complete removal group (1-, 3- and 5-year: 71.2, 58.0 and 49.7%, respectively) than in the control group (45.9, 23.0 and 15.3%, respectively, p = 0.0477). LN metastasis was not the cause of death in any of the patients in the complete removal group, whereas it was a cause in some patients in the control group. No local LN recurrence was identified in the complete removal group. CONCLUSIONS The present results suggest that the complete removal of metastatic LN from HCC is clinically beneficial in selected patients.
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6
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Zhou YM, Zhang XF, Yu F, Liu XB, Wu LP, Li B, Yang JM. Efficacy of surgical resection for pulmonary metastases from hepatocellular carcinoma. Med Sci Monit 2014; 20:1544-9. [PMID: 25172966 PMCID: PMC4156333 DOI: 10.12659/msm.890853] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background The lung is one of the most common sites for extrahepatic metastasis from hepatocellular carcinoma (HCC). This study aimed to assess the efficacy of surgical resection for pulmonary metastases from HCC. Material/Methods The medical records of 9 patients who underwent pulmonary metastasectomy from HCC at 2 institutions were retrospectively studied, together with a review of studies reporting the outcomes of at least 5 patients in the Chinese and English languages. Results There were no perioperative deaths or major complications. The 1-, 3-, and 5-year overall survival rate after surgery was 100%, 44.4%, and 33.3%, respectively. A total of 19 studies involving 443 patients who underwent pulmonary metastasectomy for metastasis of HCC were included in the literature review. The median mortality rate was 0% (range, 0–7.1%). The median survival ranged from 10.7 to 77 (median=33.2) months, and the 5-year overall survival rate ranged from 11.5% to 75% (median=36%). Conclusions Surgical resection is a safe and effective treatment in selected patients with pulmonary metastases from HCC.
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Affiliation(s)
- Yan-Ming Zhou
- Department of Hepatobiliary and Pancreatovascular Surgery, Oncologic Center of Xiamen, First affiliated Hospital of Xiamen University, Xiamen, China (mainland)
| | - Xiao-Feng Zhang
- Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China (mainland)
| | - Feng Yu
- Department of Hepatobiliary Surgery, 101th Hospital of Chinese PLA, Wuxi, China (mainland)
| | - Xiao-Bin Liu
- Department of Hepatobiliary and Pancreatovascular Surgery, Oncologic Center of Xiamen, First affiliated Hospital of Xiamen University, Xiamen, China (mainland)
| | - Lu-Peng Wu
- Department of Hepatobiliary and Pancreatovascular Surgery, Oncologic Center of Xiamen, First affiliated Hospital of Xiamen University, Xiamen, China (mainland)
| | - Bin Li
- Department of Hepatobiliary and Pancreatovascular Surgery, Oncologic Center of Xiamen, First affiliated Hospital of Xiamen University, Xiamen, China (mainland)
| | - Jia-Mei Yang
- Department of Special Treatment, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China (mainland)
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7
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Bortezomib induces tumor-specific cell death and growth inhibition in hepatocellular carcinoma and improves liver fibrosis. J Gastroenterol 2013; 48:738-50. [PMID: 23011081 DOI: 10.1007/s00535-012-0675-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 08/23/2012] [Indexed: 02/04/2023]
Abstract
BACKGROUND Human hepatocellular carcinoma (HCC) is highly ubiquitinated. The ubiquitination is important to the generatation of HCC. The antitumor and antifibrosis effects of an ubiquitin-proteasome system inhibitor, bortezomib, on HCC with liver cirrhosis (LC) were analyzed in vitro and in vivo. METHODS The effect of bortezomib was analyzed in the rat hepatocarcinogenesis model using a DEN and CDAA diet (DEN/CDAA model), which shows severe LC and generation of HCC. The decrease of GST-P-positive foci and HCC were analyzed in vivo. Cell death was analyzed by cell death detection kit. Liver fibrosis was checked by sirius-red staining and α-smooth muscle actin staining. The in vitro study involved 3 HCC cell lines (HepG2, HuH7, and HLF) and primary rat and human hepatocytes. The proliferation rate of the HCC cell line was analyzed using the MTT assay and FACS analysis. The toxicity of bortezomib was checked using the LDH release assay for primary human and rat hepatocytes. RESULTS In the rat hepatocarcinogenesis model, bortezomib prevented the development of preneoplastic lesions during the early stages of hepatocarcinogenesis and specifically induced cell death in HCC. Furthermore, bortezomib inhibited cell proliferation and induced tumor-specific cell death in HCC cell lines with decrease of cyclin D1 and phospho-Rb expression. Further, bortezomib showed no hepatotoxicity of primary rat and human hepatocytes, suggesting that it might be an HCC-specific drug. Bortezomib also prevented the activation of hepatic stellate cells and inhibited the liver fibrosis of the DEN/CDAA model. CONCLUSIONS Bortezomib appears to be an ideal target drug for HCC with LC.
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Thompson MD, Dar MJ, Monga SPS. Pegylated interferon alpha targets Wnt signaling by inducing nuclear export of β-catenin. J Hepatol 2011; 54:506-12. [PMID: 21093092 PMCID: PMC3052972 DOI: 10.1016/j.jhep.2010.07.020] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2009] [Revised: 06/25/2010] [Accepted: 07/17/2010] [Indexed: 12/26/2022]
Abstract
BACKGROUND & AIMS Pegylated-Interferon-α2a (peg-IFN), a first line therapy for Hepatitis C virus (HCV) patients, also impacts the recurrence of hepatocellular carcinoma (HCC). The activation of the Wnt pathway due to β-catenin gene mutations contributes to the development of a significant subset of HCC. Herein, we explored the effect of peg-IFN on Wnt/β-catenin signaling in vitro and in vivo. METHODS Multiple human hepatoma cell lines were treated with Peg-IFN to assess its effect on the Wnt pathway and the mechanisms involved. Transgenic (TG) mice expressing stable β-catenin mutant in the liver were exposed to diethylnitrosamine (DEN) and treated with peg-IFN. RESULTS In vitro, peg-IFN decreased the transcriptional activity of β-catenin/Tcf and did so independently of JAK/Stat signaling. Peg-IFN treatment led to increased mRNA and protein expression of RanBP3, a known β-catenin nuclear export factor, in all hepatoma cells. Co-precipitation studies showed an increased association between RanBP3 and β-catenin after peg-IFN treatment. The siRNA-mediated RanBP3 knockdown abrogated Peg-IFN-induced decrease in TOPFlash reporter activity. In vivo, Peg-IFN treatment led to increased nuclear RanBP3, decreased nuclear β-catenin and cyclin D1, and decreased cytoplasmic glutamine synthetase. Increased association of RanBP3 and β-catenin was also observed in vivo in response to Peg-IFN that led to decreased hepatocyte proliferation. CONCLUSIONS Peg-IFN inhibits β-catenin signaling through the up-regulation of RanBP3, which may be a contributory mechanism for the delayed HCC and improved survival in treated HCV patients. This observation might have chemo-preventive or chemo-therapeutic implications in tumor with aberrant Wnt pathway activation.
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Affiliation(s)
- Michael D. Thompson
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Mohd Jamal Dar
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
| | - Satdarshan P. S. Monga
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15261, Department of Medicine (Gastroenterology, Hepatology and Nutrition), University of Pittsburgh School of Medicine, Pittsburgh, PA 15261
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9
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Yan ML, Wang YD, Lai ZD, Tian YF, Chen HB, Qiu FN, Zhou SQ. Pedunculated hepatocellular carcinoma and splenic metastasis. World J Gastroenterol 2009; 15:5239-41. [PMID: 19891029 PMCID: PMC2773909 DOI: 10.3748/wjg.15.5239] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Only a few cases of pedunculated hepatocellular carcinoma (P-HCC) have been reported in the literature. The common sites of extrahepatic metastases in patients with HCC are the lungs, regional lymph nodes, kidney, bone marrow and adrenals. Metastasis to spleen is mostly via hematogenous metastasis, direct metastasis to spleen was very rare. We report a case of P-HCC presenting as a left upper abdominal lesions which involved the spleen that was actually a P-HCC with splenic metastasis. This case is unique as P-HCC directly involved the spleen which is not via hematogenous metastasis.
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10
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Nakamura M, Nagano H, Marubashi S, Miyamoto A, Takeda Y, Kobayashi S, Wada H, Noda T, Dono K, Umeshita K, Monden M. Pilot study of combination chemotherapy of S-1, a novel oral DPD inhibitor, and interferon-alpha for advanced hepatocellular carcinoma with extrahepatic metastasis. Cancer 2008; 112:1765-71. [PMID: 18327806 DOI: 10.1002/cncr.23356] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND To the authors' knowledge, there is no effective therapy for extrahepatic metastasis of hepatocellular carcinoma (HCC). In a pilot study, the results of combination therapy of S-1, a novel oral dehydropyrimidine dehydrogenase (DPD) inhibitor, and interferon-alpha (IFN-alpha) are reported for HCC patients with extrahepatic metastasis. METHODS Twelve patients with extrahepatic metastasis of HCC were enrolled in the pilot study. S-1 was administered orally at a dose based on body surface area, twice daily after a meal, for 4 weeks. IFN-alpha was injected subcutaneously on Days 1, 3, and 5 of each week. One course consisted of consecutive administration for 28 days followed by 14 days rest. RESULTS An objective response was observed in 3 (25%) of 12 patients. The overall 1-year survival rate was 61.7%. Grade 3 leukocytopenia was observed in 1 patient (8.3%). No severe toxicity or treatment-related deaths were observed. CONCLUSIONS The combination therapy of S-1 and IFN-alpha appears to be highly efficacious, with low toxicity in patients with extrahepatic metastases of HCC. The combination chemotherapy of oral S-1 and subcutaneous IFN-alpha is a potentially promising treatment strategy for advanced HCC with extrahepatic metastasis.
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Affiliation(s)
- Masato Nakamura
- Department of Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan
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11
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Oie S, Ono M, Fukushima H, Hosoi F, Yano H, Maruyama Y, Kojiro M, Terada T, Hirano K, Kuwano M, Yamada Y. Alteration of dihydropyrimidine dehydrogenase expression by IFN-α affects the antiproliferative effects of 5-fluorouracil in human hepatocellular carcinoma cells. Mol Cancer Ther 2007; 6:2310-8. [PMID: 17699726 DOI: 10.1158/1535-7163.mct-06-0281] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Dihydropyrimidine dehydrogenase (DPD) is the rate-limiting enzyme in the catabolism of 5-fluorouracil (5-FU) and its activity is closely associated with cellular sensitivity to 5-FU. This study examines the role of DPD in the antiproliferative effects of 5-FU combined with IFN-alpha on hepatocellular carcinoma (HCC) cells in culture and asks whether IFN-alpha could affect DPD expression. The combined action of IFN-alpha and 5-FU on three HCC lines was quantified by a combination index method. Coadministration of IFN-alpha and 5-FU showed synergistic effects against HAK-1A and KYN-2 but antagonistic effects against KYN-3. The cellular expression levels of DPD mRNA and protein were markedly up-regulated in KYN-3 cells by IFN-alpha but were down-regulated in HAK-1A and KYN-2. The expression of thymidylate synthase mRNA and protein was down-regulated by IFN-alpha in all three cell lines. Coadministration of a selective DPD inhibitor, 5-chloro-2,4-dihydroxypyridine (CDHP), enhanced the antiproliferative effect of 5-FU and IFN-alpha on KYN-3 approximately 4-fold. However, the synergistic effects of 5-FU and IFN-alpha on HAK-1A and KYN-2 were not affected by CDHP. The antiproliferative effect of 5-FU could thus be modulated by IFN-alpha, possibly through DPD expression, in HCC cells. Inhibition of DPD activity by CDHP may enhance the efficacy of IFN-alpha and 5-FU combination therapy in patients with HCC showing resistance to this therapy.
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Affiliation(s)
- Shinji Oie
- Station-II for Collaborative Research, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, Japan 812-8582.
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