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Annals of Oncology Advance Access published online on June 5, 2009
Annals of Oncology, doi:10.1093/annonc/mdp010
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org

Combination chemotherapy with capecitabine and cisplatin for patients with metastatic hepatocellular carcinoma

J. O. Lee1, K. W. Lee2, D. Y. Oh1,3,*, J. H. Kim2, S. A. Im1,3, T. Y. Kim1,3 and Y. J. Bang1,3

1 Department of Internal Medicine, Seoul National University Hospital
2 Department of Internal Medicine, Seoul National University Bundang Hospital
3 Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea

* Correspondence to: Dr D. Y. Oh, Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 28 Yongondong Chongno-gu, Seoul 110-744, Korea. Tel: +82-2-2072-0701; Fax: +82-2-762-9662; E-mail: ohdoyoun{at}snu.ac.kr

Background: We evaluated the efficacy and toxicity of combination chemotherapy with capecitabine and cisplatin (XP) in patients with metastatic hepatocellular carcinoma (HCC).

Patients and methods: From September 2003 to July 2007, we enrolled patients with HCC who had more than one measurable extrahepatic metastatic lesion. Patients received oral capecitabine (2000 mg/m2/day) with a schedule of 2 weeks on and 1 week off and cisplatin (60 mg/m2) on the first day of the 3-week cycle.

Results: The study cohort consisted of 32 patients with a median age of 53 years. Overall response rate was 6.3% and disease control rate was 34.4%. The median time to progression (TTP) was 2.0 months [95% confidence interval (CI) 1.5–2.4] and the median overall survival (OS) time was 12.2 months (95% CI 6.5–17.8). The grade 3/4 hematologic toxic effects included thrombocytopenia (7.6%), neutropenia (4.3%) and anemia (2.1%). The grade 3/4 non-hematologic toxic effects included elevated hepatic aminotransferase (12.9%), jaundice (3.2%), mucositis (3.2%) and nausea (3.2%). There was no treatment-related mortality.

Conclusions: Based on the observed response rate and TTP, XP combination chemotherapy showed modest antitumor efficacy in patients with metastatic HCC as systemic first-line treatment. However, XP combination chemotherapy showed tolerable toxicity and demonstrated favorable OS time.

capecitabine, cisplatin, hepatocellular carcinoma, metastasis

Received for publication July 13, 2008. Revision received November 26, 2008. Accepted for publication January 8, 2009.


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