title: Initial experience with hepatic intraarterial fotemustine and interferon alpha 2b combination for treatment of liver tumors.
abstract: BACKGROUND
  Locoregional treatments represent a good option for patients suffering from hepatocellular carcinoma (HCC) not eligible for resection or transplantation. Locoregional approaches include a wide spectrum of therapeutic methods and hepatic intra-arterial drug infusion is also considered. Fotemustine is a chemotherapy drug usually administered intravenously according to standard administration schedules. Interferon alpha 2b (IFNα2b), a biological response modifier conventionally administered by a systemic route, has been employed in the treatment of both virus-related hepatitis and HCC. Nonetheless, both drugs can also be infused into the hepatic artery.
  
  
  METHODS
  We report on five patients with liver cancer, not suitable for conventional therapies, treated with hepatic intra-arterial administration of fotemustine in combination with IFNα2b. They received fotemustine at a dose of 30 mg/m(2) and IFNα2b at a starting dose of 2,000,000 IU (increasing up to 3,000,000 IU for subsequent administrations) weekly for three consecutive weeks, followed by two weeks of rest.
  
  
  RESULTS
  Among the patients suffering from HCC, the first patient showed a partial response, two patients had almost stable disease and one patient was not assessable. A patient with an intrahepatic biliary tract cancer experienced disease progression.
  
  
  CONCLUSIONS
  The therapeutic regimen used showed acceptable tolerability profiles and lack of life-threatening side-effects. Further evaluation with a larger patient cohort will be required to clarify if fotemustine and IFNα2b administered into the hepatic artery could be beneficial in treating patients with HCC.
authors.affiliation: Department of Oncology, Division of Medical Oncology, San Vincenzo Hospital, Contrada Sirina, 98039 Taormina (ME), Italy. f.vitale@videobank.it
authors.forename: Felice Vito
authors.initials: FV
authors.lastname: Vitale
authors.forename: Placido
authors.initials: P
authors.lastname: Romeo
authors.forename: Enrico Maria
authors.initials: EM
authors.lastname: DI Maggio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Parisi
authors.forename: Emilia
authors.initials: E
authors.lastname: Malaponte
authors.forename: Stefania
authors.initials: S
authors.lastname: Calì
authors.forename: Fabio
authors.initials: F
authors.lastname: Vasta
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Panebianco
authors.forename: Domenico
authors.initials: D
authors.lastname: Arcoria
authors.forename: Francesco
authors.initials: F
authors.lastname: Ferraù
mesh_terms: D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001706:Biopsy; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial / Q000379:methods*; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000008:administration & dosage*; D008099:Liver / Q000098:blood supply*; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009607:Nitrosourea Compounds / Q000008:administration & dosage*; D009943:Organophosphorus Compounds / Q000008:administration & dosage*; D011994:Recombinant Proteins / Q000008:administration & dosage; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000077190:Interferon alpha-2; D016898:Interferon-alpha; D009607:Nitrosourea Compounds; D009943:Organophosphorus Compounds; D011994:Recombinant Proteins; C054368:fotemustine