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Impact of biomarkers on disease survival and progression in patients treated with octreotide for advanced hepatocellular carcinoma

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Abstract

Background

Current determination of prognosis for advanced hepatocellular carcinoma (HCC) is mainly based on clinical assessment. We aimed to determine the impact of biomarkers as predictive factors for HCC progression and survival during octreotide-based treatments.

Patients and methods

We included patients who had been prospectively randomised to receive either octreotide (30 mg) alone monthly (n = 39) or in combination with rofecoxib (up to 50 mg bid daily, n = 32) for a minimum of 6 months, or until death occurred.

Results

Overall median survival (154 days) and median time to progression (94 days) were not different for both treatments and the biomarkers investigated (VEGF-A, IGF-1, PGE-2, ET-A) were similarly distributed amongst treatment groups. Combined univariate group analysis revealed that survival was decreased for an uptake ratio of > 2 on initial octreoscan (P = 0.05); baseline serum VEGF-A and IGF-1 were further significantly associated with survival. On multivariate analysis, uncorrected serum VEGF-A appeared to be the most significant predictor for tumor progression and survival.

Conclusions

Biomarkers, in addition to established tumor markers, are independent predictors of tumor progression and survival in patients with advanced HCC treated with octreotide. Furthermore, the involvement of VEGF-A implies the inhibition of angiogenesis as a potential mechanism of action for this drug.

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Acknowledgments

Dr S. Schulz (Department of Pharmacology and Toxicology, University of Magdeburg, Germany) kindly provided antibodies for immunohistochemical detection of SSTR-2. The extensive laboratory work of Mrs. U. Stolz and the excellent patient care by our study nurse Mrs. M. Leucke is highly appreciated. We thank Dr S. Gerber (Institute of Immunology, University of Magdeburg, Germany) for s-IL2 measurement. We also thank Sanko Junyaku Co., Ltd., Tokyo, Japan for providing us the PIVKA-II ELISA kits. We are indebted to all the patients who took part in the study and to their families.

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Authors and Affiliations

  1. Department of Gastroenterology and Hepatology, University Hospital of Magdeburg, Magdeburg, Germany

    G. Treiber, T. Wex & P. Malfertheiner

  2. Department of Pathology, University Hospital of Magdeburg, Magdeburg, Germany

    C. Röcken

  3. Department of Nuclear Medicine, University Hospital of Magdeburg, Magdeburg, Germany

    P. Fostitsch

  4. Department of Internal Medicine II, Saarland University Hospital, Kirrberger Street, 66421, Homburg, Germany

    G. Treiber

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  1. G. Treiber
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Correspondence to G. Treiber.

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Treiber, G., Wex, T., Röcken, C. et al. Impact of biomarkers on disease survival and progression in patients treated with octreotide for advanced hepatocellular carcinoma. J Cancer Res Clin Oncol 132, 699–708 (2006). https://doi.org/10.1007/s00432-006-0118-4

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  • DOI: https://doi.org/10.1007/s00432-006-0118-4

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