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A phase I/II trial of capecitabine combined with peginterferon α-2a in Patients with sorafenib-refractory advanced hepatocellular carcinoma

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Summary

Background Several pilot studies have demonstrated the effectiveness of combination therapy with pyrimidine fluoride and interferon for advanced hepatocellular carcinoma.This study aimed to determine the recommended dose of capecitabine combined with peginterferon α-2a (Phase I) and evaluate its safety and efficacy for sorafenib-refractory advanced hepatocellular carcinoma (Phase II). Methods Capecitabine was administered daily on days 1–14, while peginterferon α-2a was administered on days 1, 8, and 15. The cycle was repeated every 21 days. The patients were scheduled to receive capecitabine [mg/(m2∙day)] and peginterferon α-2a (μg/week) at 3 dose levels in phase I: 1200 and 90 (level 1), 1600 and 90 (level 2), and 2000 and 90 (level 3), respectively. Results A total of 30 patients were enrolled. The recommended dose was level 3. Among the 24 patients receiving the drug at the recommended dosage, 2 (8 %) exhibited a partial response, 9 (38 %) exhibited stable disease, 10 (42 %) exhibited progressive disease, and 3 (13 %) were not evaluated. The median time to progression and overall survival were 3.0 months and 7.2 months, respectively. The most common toxicities were decreased white blood cell (88 %), neutrophil (88 %), and platelet counts (58 %); fatigue (50 %); and palmar–plantar erythrodysesthesia syndrome (42 %). Four patients (17 %) discontinued treatment because of severe adverse events. Conclusion Capecitabine at 2000 mg/(m2∙day) combined with peginterferon α-2a (90 μg/week) exhibited moderate, albeit manageable, toxicity and was declared as the recommended phase II dose. Further research is required to refine the efficacy of this combination.

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Acknowledgments

We express our heartfelt thanks and gratitude to the patients and their families.

Conflicts of Interest

Prof. Osamu Yokosuka received research grants from Chugai Pharmaceutical Co., Ltd. Sadahisa Ogasawara, Tetsuhiro Chiba, Yoshihiko Ooka, Naoya Kanogawa, Tenyu Motoyama, Eiichiro Suzuki, Akinobu Tawada, and Fumihiko Kanai declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Sadahisa Ogasawara, Tetsuhiro Chiba, Yoshihiko Ooka, Naoya Kanogawa, Tenyu Motoyama, Eiichiro Suzuki, Akinobu Tawada, Fumihiko Kanai & and Osamu Yokosuka

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  1. Sadahisa Ogasawara
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  2. Tetsuhiro Chiba
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  3. Yoshihiko Ooka
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  4. Naoya Kanogawa
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  5. Tenyu Motoyama
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  6. Eiichiro Suzuki
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  7. Akinobu Tawada
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  8. Fumihiko Kanai
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  9. and Osamu Yokosuka
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Correspondence to Tetsuhiro Chiba.

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Ogasawara, S., Chiba, T., Ooka, Y. et al. A phase I/II trial of capecitabine combined with peginterferon α-2a in Patients with sorafenib-refractory advanced hepatocellular carcinoma. Invest New Drugs 32, 762–768 (2014). https://doi.org/10.1007/s10637-014-0097-2

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  • DOI: https://doi.org/10.1007/s10637-014-0097-2

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