Heparanase inhibitor PI-88 as adjuvant therapy for hepatocellular carcinoma after curative resection: a randomized phase II trial for safety and optimal dosage.

Abstract:

BACKGROUND/AIMS:Hepatocellular carcinoma recurrence after curative treatment adversely influences clinical outcome. It is important to explore adjuvant therapies. This phase II/stage 1 multi-center, randomized trial investigated the safety, optimal dosage and preliminary efficacy of PI-88, a novel heparanase inhibitor, in the setting of post-operative recurrence of HCC according to a Simon's 2-stage design. METHODS:Three groups were included: one untreated arm (Group A) and two PI-88 arms (Group B: 160 mg/day; Group C: 250 mg/day). Treatment groups received PI-88 over nine 4-week treatment cycles, followed by a 12-week treatment-free period. Safety and optimal dosage were assessed. RESULTS:Overall, 172 patients were randomized and 168 were included in the intention-to-treat (ITT) population. Treatment-related adverse effects included cytopenia, injection site hemorrhage, PT prolongation, etc. Four serious adverse events were possibly related to PI-88 treatment. One (1.8%) group B patients and six (10.5%) group C had hepatotoxicity-related withdrawals. Among the ITT population, 29 patients (50%) in Group A, 35 (63%) in Group B, and 22 (41%) in Group C remained recurrence-free at completion. Calculated T(1) value suggested 160 mg/day treatment satisfied the criteria for the next stage of the trial. CONCLUSIONS:PI-88 at 160 mg/day is optimal and safe, and shows preliminary efficacy as an adjunct therapy for post-operative HCC.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Liu CJ,Lee PH,Lin DY,Wu CC,Jeng LB,Lin PW,Mok KT,Lee WC,Yeh HZ,Ho MC,Yang SS,Lee CC,Yu MC,Hu RH,Peng CY,Lai KL,Chang SS,Chen PJ

doi

10.1016/j.jhep.2008.12.023

subject

Has Abstract

pub_date

2009-05-01 00:00:00

pages

958-68

issue

5

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(09)00056-7

journal_volume

50

pub_type

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