Pilot study: Rapamycin in advanced hepatocellular carcinoma

Maximilian Schöniger-Hekele (1) , Christian Müller (2)

1 Klinik Innere Medizin III, Gastroenterology and Hepatology
2 Klinik Innere Medizin III, Gastroenterology and Hepatology

Introduction: The PI3K/Akt/mTOR signal pathway is involved in hepatocarcinogenesis. Rapamycin (= Sirolimus), a specific mTOR inhibitor, leads to G(1) arrest of many malignant cell lines, and currently analogs of rapamycin are being investigated as a cancer chemotherapeutic adjuvant. Aim: To study the toxicity and tolerability of rapamycin therapy in patients with advanced hepatocellular carcinoma (HCC). Methods: Between June 2005 and February 2007 patients with advanced HCC, not eligible for any established therapy, were included in the study. Results: 18 patients (f/m: 5/13) with compensated liver cirrhosis (Child A n= 11, Child B n= 5, Child C n=2) and histologically proven HCC were included in this study. According to the BCLC staging system most of the patients enrolled had an advanced HCC: BCLC stage B: n=2, BCLC stage C: n=14, BCLC stage D: n=2. Overall, therapy with rapamycin was well tolerated. Most common toxicities were thrombocytopenia and anemia. We did not observe any partial or complete tumor response. At 3 months two patients had stable disease, at 6 months all patients had progressed. The median overall survival was 5.27 months, median time to progression was 3 months. Conclusion: Rapamycin is well tolerated in patients with advanced HCC but only minimally effective.

Mots clés: Medicine

Maximilian Schöniger-Hekele, Christian Müller. Pilot study: Rapamycin in advanced hepatocellular carcinoma. Alimentary Pharmacology and Therapeutics, 2010, 32 (6), pp.763. ⟨10.1111/j.1365-2036.2010.04404.x⟩. ⟨hal-00555326⟩