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Japanese Journal of Clinical Oncology 33:570-573 (2003)
© 2003 Foundation for Promotion of Cancer Research

A Phase I Study of Hepatic Arterial Infusion Chemotherapy with Zinostatin Stimalamer Alone for Hepatocellular Carcinoma

Hiroshi Ishii1, Junji Furuse1, Michitaka Nagase1, Yasushi Maru1,3, Masahiro Yoshino1 and Takayuki Hayashi2,+

1 Division of Hepatobiliary and Pancreatic Medical Oncology and 2 Department of Radiology, National Cancer Center Hospital East, Kashiwa, Chiba and 3 Department of Internal Medicine, Chiba Social Insurance Hospital, Chiba, Japan

Background: Hepatic arterial infusion of zinostatin stimalamer and lipiodol emulsion shows a moderate activity against hepatocellular carcinoma. However, the anti-tumor activity of zinostatin stimalamer alone is uncertain.

Methods: The primary endpoint was to evaluate the frequency of dose-limiting toxicity and determine the maximum-tolerated dose of zinostatin stimalamer when used by intra-arterial infusion. The candidates for this study were patients with hepatocellular carcinoma no longer amenable to established forms of treatment. Hepatic arterial infusion chemotherapy was performed by selectively introducing a catheter into the hepatic artery with zinostatin stimalamer alone. Treatment was repeated at 4–8-week intervals until disease progression or the appearance of unacceptable toxicity. The starting dose of zinostatin stimalamer was 3 mg/m2, and doses were increased in 1 mg/m2 increments in successive cohorts. At least three patients were treated at each dose level and three additional patients were treated in the presence of dose-limiting toxicity.

Results: Twelve patients were entered into this trial. Dose-limiting toxicity was observed in one of six patients at 3 mg/m2, and in two of six patients at 4 mg/m2. The maximum-tolerated dose was judged to be 3 mg/m2 with liver dysfunction and serum creatinine increase as the dose-limiting toxicity. There was one early death suggested to be related to the protocol treatment. None of the 12 patients achieved an objective tumor response.

Conclusion: Hepatic arterial infusion with a zinostatin stimalamer of 3 mg/m2 may be tolerated, but not active, in patients with far advanced hepatocellular carcinoma.

+ For reprints and all correspondence: Hiroshi Ishii, Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan. E-mail: hirishii{at}east.ncc.go.jp


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