title: Long-lasting response with metronomic capecitabine in advanced hepatocellular carcinoma.
abstract: Effective and safe systemic treatment for advanced hepatocellular carcinoma (HCC) with severe underlying cirrhosis is not yet available. Sorafenib, an oral multikinase inhibitor, has proved to be effective in the treatment of patients affected by HCC with Child-Pugh class A liver function. For patients with cirrhosis-associated HCC having Child-Pugh class B and C liver function, no systemic treatments of documented efficacy and safety exist. We report a case of metastatic HCC associated with Child-Pugh class B cirrhosis that was treated with low, "metronomic" doses of capecitabine (1000 mg/day continuously). This treatment was effective and well tolerated and the response was maintained for 18 months. Metronomic capecitabine may represent a possible alternative in the treatment of those patients with advanced cirrhosis-associated HCC who cannot be treated with sorafenib.
authors.affiliation: Department of Internal Medicine, Lagosanto (FE), Azienda USL of Ferrara, Italy. p.ballardini@ausl.fe.it
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Ballardini
authors.forename: Ivan
authors.initials: I
authors.lastname: Marri
authors.forename: Guido
authors.initials: G
authors.lastname: Margutti
authors.forename: Camillo
authors.initials: C
authors.lastname: Aliberti
authors.forename: Giorgio
authors.initials: G
authors.lastname: Benea
authors.forename: Roberto
authors.initials: R
authors.lastname: Manfredini
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage / Q000627:therapeutic use*; D000069287:Capecitabine; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000209:etiology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil