Opioid growth factor (OGF) for hepatoblastoma: a novel non-toxic treatment
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Hepatoblastoma is the most common liver malignancy in children, typically diagnosed before age 2. The survival rate for hepatoblastoma has increased dramatically in the last 30 years, but the typical chemotherapeutic agents used for treatment are associated with significant toxicity. In this report, the authors present two cases of hepatoblastoma treated with surgical resection and a novel biotherapeutic regimen that included opioid growth factor (OGF). Case #1 is an infant diagnosed with a large mass on prenatal ultrasound. After subsequent diagnosis of hepatoblastoma, she was treated with one course of neoadjuvant chemotherapy at approximately 1 week of age. Following significant complications from the chemotherapy (neutropenic fever, pneumonia and sepsis), the patient’s parents declined further chemotherapy, and the infant was treated with surgical resection and opioid growth factor (OGF)/low dose naltrexone (LDN). She is currently at close to 10 years disease–free survival. Case #2 is a child diagnosed with a liver mass on ultrasound at 20 months of age, later biopsy-proven to represent hepatoblastoma. Due to existing co-morbidities including autosomal recessive polycystic kidney disease and hypertension, and indications from the biopsy that the tumor might be insensitive to chemotherapy, the parents elected not to proceed with neoadjuvant chemotherapy. The patient was treated with surgical resection and OGF/LDN, and is currently at more than 5 years disease-free survival. This case series highlights the need for less toxic treatment options than conventional chemotherapy. Modulation of the OGF-OGF receptor axis represents a promising safe and therapeutic avenue for effective treatment of hepatoblastoma.
KeywordsHepatoblastoma Opioid growth factor Toxicity Naltrexone LDN Disease-free survival
The authors would like to thank Margaret McKernan, MD for assistance in manuscript preparation.
Conflicts of interest
I.S. Zagon and P.J. McLaughlin hold a patent on the use of OGF in gastrointestinal cancer treatment.
All treatments described in the report complied with the current laws of Israel and the United States.
- 17.Zagon IS, Hytrek SD, Lang CM, Smith JP, McGarrity TJ, Wu Y, McLaughlin PJ (1996) Opioid growth factor ([Met5]-enkephalin) prevents the incidence and retards the growth of human colon cancer. Am J Physiol Regul Integr Comp Physiol 271:R780–R786Google Scholar
- 20.Avella DM, Kimchi ET, Donahue RN, Tagaram HR, McLaughlin PJ, Zagon IS, Staveley-O'Carroll KF (2010) The opioid growth factor-opioid growth factor receptor axis regulates cell proliferation of human hepatocellular cancer. Am J Physiol Regul Integr Comp Physiol 298(2):R459–R466CrossRefPubMedGoogle Scholar
- 22.Jaglowski JR, Zagon IS, Stack BC, Verderame MF, Leure-duPree AE, Manning JD, McLaughlin PJ (2005) Opioid growth factor enhances tumor growth inhibition and increases the survival of paclitaxel-treated mice with squamous cell carcinoma of the head and neck. Cancer Chemother Pharmacol 56:97–104CrossRefPubMedGoogle Scholar
- 23.Zagon IS, Jaglowski JR, Verderame MF, Leure-duPree AE, Smith JP, McLaughlin PJ (2005) Combination chemotherapy with gemcitabine and biotherapy with opioid growth factor (OGF) enhances the growth inhibition of pancreatic adenocarcinoma. Cancer Chemother Pharmacol 56:510–520CrossRefPubMedGoogle Scholar
- 25.Stambuk N et al (1997) Peptid-M (LUPEX) immunotherapy in multiple sclerosis, optic neuritis and uveitis. Int J Thymol 5(9):448–464Google Scholar
- 26.Wybran J, Plotnikoff NP (1991) Methionine-enkephalin, a new lymphokine for the treatment of ARC patients. In: Plotnikoff NJ, Murgo AJ, Faith R, Wybran J (eds) Stress and immunity. CRC Press, Boca RatonGoogle Scholar
- 27.Bihari B, Plotnikoff NP (1999) Methionine enkephalin in the treatment of AIDS-related complex. In: Plotnikoff NP, Murgo A, Faith RE, Good RA (eds) Cytokines stress & immunity. CRC Press, Boca RatonGoogle Scholar
- 34.Smith JP, Bingaman SI, Mauger DT, Harvey HH, Demers LM, Zagon IS (2010) Opioid growth factor improves clinical benefit and survival in patients with advanced pancreatic cancer. Open Access J Clin Trials 2:37–48Google Scholar
- 38.Gironi M, Martinelli-Boneschi F, Sacerdote P, Solaro C, Zaffaroni M, Cavarretta R, Moiola L, Bucello S, Radaelli M, Pilato V, Rodegher M, Cursi M, Franchi S, Martinelli V, Nemni R, Comi G, Martino G (2008) A pilot trial of low dose naltrexone in primary progressive multiple sclerosis. Mult Scler 14:1076–1083CrossRefPubMedGoogle Scholar