title: Peretinoin after curative therapy of hepatitis C-related hepatocellular carcinoma: a randomized double-blind placebo-controlled study.
abstract: BACKGROUND
  Effective prophylactic therapies have not been established for hepatocellular carcinoma recurrence. Peretinoin represents one novel option for patients with hepatitis C virus-related hepatocellular carcinoma (HCV-HCC), and it was tested in a multicenter, randomized, double-blind, placebo-controlled study.
  
  
  METHODS
  Patients with curative therapy were assigned to one of the following regimens: peretinoin 600, 300 mg/day, or placebo for up to 96 weeks. The primary outcome was recurrence-free survival (RFS).
  
  
  RESULTS
  Of the 401 patients initially enrolled, 377 patients were analyzed for efficacy. The RFS rates in the 600-mg group, the 300-mg group, and the placebo group were 71.9, 63.6, and 66.0 % at 1 year, and 43.7, 24.9, and 29.3 % at 3 years, respectively. The primary comparison of peretinoin (300 and 600-mg) with placebo was not significant (P = 0.434). The dose-response relationship based on the hypothesis that "efficacy begins to increase at 600 mg/day" was significant (P = 0.023, multiplicity-adjusted P = 0.048). The hazard ratios for RFS in the 600-mg group vs. the placebo group were 0.73 [95 % confidence interval (CI) 0.51-1.03] for the entire study period and 0.27 (95 % CI 0.07-0.96) after 2 years of the randomization. Common adverse events included ascites, increased blood pressure, headache, presence of urine albumin, and increased transaminases.
  
  
  CONCLUSIONS
  Although the superiority of peretinoin to placebo could not be validated, 600 mg/day was shown to be the optimal dose, and treatment may possibly reduce the recurrence of HCV-HCC, particularly after 2 years. The efficacy and safety of peretinoin 600 mg/day should continue to be evaluated in further studies.
authors.affiliation: Shimonoseki Kohsei Hospital, Kamishinchi-Machi 3-3-8, Shimonoseki, Yamaguchi, 750-0061, Japan, k.okita@kousei-h.jp.
authors.forename: Kiwamu
authors.initials: K
authors.lastname: Okita
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi
authors.forename: Osamu
authors.initials: O
authors.lastname: Matsui
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Tanaka
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
authors.forename: Hisataka
authors.initials: H
authors.lastname: Moriwaki
authors.forename: Kenji
authors.initials: K
authors.lastname: Ikeda
authors.forename: Yukio
authors.initials: Y
authors.lastname: Osaki
authors.forename: Kazushi
authors.initials: K
authors.lastname: Numata
authors.forename: Kohei
authors.initials: K
authors.lastname: Nakachi
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
authors.forename: Kazuho
authors.initials: K
authors.lastname: Imanaka
authors.forename: Shuhei
authors.initials: S
authors.lastname: Nishiguchi
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Susumu
authors.initials: S
authors.lastname: Shiomi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kudo
authors.forename: Kenichi
authors.initials: K
authors.lastname: Ido
authors.forename: Yoshiyasu
authors.initials: Y
authors.lastname: Karino
authors.forename: Norio
authors.initials: N
authors.lastname: Hayashi
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Ohashi
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Makuuchi
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
mesh_terms: D000368:Aged; D016588:Anticarcinogenic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000556:secondary / Q000628:therapy / Q000821:virology*; D018572:Disease-Free Survival; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control; D012176:Retinoids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D016588:Anticarcinogenic Agents; D012176:Retinoids; C487689:(2E,4E,6E,10E)-3,7,11,15-tetramethyl-2,4,6,10,14-hexadecapentaenoic acid
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