title: Hepatic intra-arterial cetuximab in combination with 5-fluorouracil and cisplatin as salvage treatment for sorafenib-refractory hepatocellular carcinoma.
abstract: BACKGROUND
  Sorafenib is the only therapy approved for advanced hepatocellular carcinoma no longer eligible for transcatheter arterial chemoembolization. Hepatic intra-arterial chemotherapy has been shown to be an effective and safe therapy for advanced hepatocellular carcinoma. Cetuximab has been administered intravenously to patients with advanced hepatocellular carcinoma, showing encouraging results in terms of its safety and toxicity profile.
  
  
  OBJECTIVE
  Our purpose was to evaluate the safety and feasibility of hepatic arterial chemotherapy with cetuximab, cisplatin and 5-fluoruracil for patients with advanced hepatocellular carcinoma, not responsive or not eligible for sorafenib therapy.
  
  
  METHODS
  From January 2010 to January 2011, 12 patients received a 2-day course of chemotherapy consisting of repeated daily hepatic arterial administration of 20 mg of cisplatin as 2-h infusion, 5-fluorouracil at 500 mg/m(2) as 5-h infusion and cetuximab 500 mg/m(2) as 12-h infusion. Cycles were repeated every 14 days.
  
  
  RESULTS
  After a mean of four months of therapy, computed tomography revealed five partial responses, five cases of stable disease and two of progressive disease. The toxicity profile was favourable, with no G4 gastrointestinal, hematologic or skin side-effects, or severe deterioration of liver function.
  
  
  CONCLUSIONS
  Hepatic intra-arterial chemotherapy with cetuximab is a safe and feasible treatment for advanced hepatocellular carcinoma, with promising results in patients with initial poor prognosis.
authors: Department of Oncology, IRCCS S. Maugeri Foundation, 10 Maugeri Street, 27100 Pavia, Italy. guido.poggi@fsm.it
authors: Guido
authors: G
authors: Poggi
authors: Benedetta
authors: B
authors: Montagna
authors: Fabio
authors: F
authors: Melchiorre
authors: Pietro
authors: P
authors: Quaretti
authors: Angelo
authors: A
authors: Delmonte
authors: Alberto
authors: A
authors: Riccardi
authors: Barbara
authors: B
authors: Tagliaferri
authors: Federico
authors: F
authors: Sottotetti
authors: Pamela
authors: P
authors: Di Cesare
authors: Maria Giulia
authors: MG
authors: Stella
authors: Laura
authors: L
authors: Villani
authors: Michele
authors: M
authors: Zorzetto
authors: Giorgio
authors: G
authors: Greco
authors: Gianpaolo
authors: G
authors: Cornalba
authors: Giovanni
authors: G
authors: Bernardo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000008:administration & dosage; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D000068818:Cetuximab; D002945:Cisplatin / Q000008:administration & dosage; D019008:Drug Resistance, Neoplasm; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000008:administration & dosage; D016879:Salvage Therapy; D000077157:Sorafenib; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib; D000068818:Cetuximab; D002945:Cisplatin; D005472:Fluorouracil