Hepatocellular Carcinoma Clinical Trial
Official title:
Adjuvant Therapy With Thalidomide After Curative Resection of Hepatocellular Carcinoma.: a Randomized Controlled Trial
Postoperative recurrence of hepatocellular carcinoma (HCC) is a major problem after surgical resection. To date, adjuvant chemotherapy or other adjuvant modalities have not been proven effective in preventing or delaying recurrence. The aim of this prospective randomized study was to evaluate the effectiveness of Thalidomide as a postoperative adjuvant regimen in inhibiting the recurrence of HCC
A number of modalities for preventing HCC recurrence after resection have been proposed and
analyzed. Both preoperative and adjuvant transcatheter arterial chemoembolization (TACE)
were found to be unable to reduce the risk of postoperative recurrence significantly, or
confer a survival advantage. Vitamin K (VK) is a fat-soluble vitamin that regulates clotting
factor production by acting as a coenzyme for a VK dependent carboxylase that catalyzes
carboxylation of glutamic acid residues into gamma-carboxyglutamic acid. The findings in
vitro have indicated that VK2 has an antiproliferative effects against hepatoma cell lines,
but its efficacy in suppressing HCC recurrence was not confirmed in human studies.
Interferon has a variety of biologic properties, including antiviral, immunomodulatory,
antiproliferative, antiangiogenic and tumoricidal effects. It is reported that interferon is
effective in preventing the development of HCC recurrence after its curative treatment in
HCV-related cirrhosis. However, interferon treatment also has side-effects, including
flu-like symptoms, fatigue, neutropenia, thrombocytopenia, depression, bone marrow
suppression, and unmasking or exacerbation of autoimmune illnesses, which lead either to
treatment disruption or dose modification. Polyprenoic acid, an acyclic retinoid, reportedly
is effective in prevention of second primary hepatomas, but long-term safety and efficacy
data are lacking.
Thalidomide possesses immunomodulatory,anti-inflammatory, and antiangiogenic properties.It
has successfully been applied for the treatment of various malignancies including HCC.To
investigated whether postoperative adjuvant therapy with Thalidomide could inhibite the
recurrence of HCC after radical resection,we planed to conduct this clinical trial.
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Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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