The only drug approved for patients with advanced primary liver cancer (hepatocellular carcinoma, or HCC) is sorafenib, also known by its brand name of Nexavar. In HCC there is often significant damage to the liver (cirrhosis). The authors of this study wondered if chemotherapeutics that are considered too dangerous for use with patients with significant liver damage, might work in patients with liver cancer who do not also have significant damage from cirrhosis. Fibrolamellar is unlikely to be the result of long-term damage to the liver. The study examined a 25 year old women who, after her primarly tumor was removed (resected) from her liver, was found to have metasteses in her lymph nodes. The patient received alternating mixtures of two drugs: gemcitabine-oxaliplatin, and five years after treatment was stopped, the woman was still clear of any signs of fibrolamellar.
Gras P, Truant S, Boige V, Ladrat L, Rougier P, Pruvot FR, Hebbar M.
Case Rep Oncol. 2012 Jan;5(1):169-72. Epub 2012 Apr 3
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The only currently validated treatment for advanced hepatocellular carcinoma (HCC) is sorafenib. However, sorafenib has been mainly studied in patients with HCC developed in cirrhotic liver. Chemotherapy might be more suitable for patients with HCC in non-cirrhotic liver. We report the case of a young woman with fibrolamellar HCC in a non-cirrhotic liver, with histologically proven metastatic ganglionary relapse after surgical resection of the primary tumour. Chemotherapy with gemcitabine and oxaliplatin (GEMOX regimen) achieved a complete response without relapse five years after discontinuation of chemotherapy. This exceptional case raises the question of clinical trials specifically designed for patients with HCC in non-cirrhotic liver.