New Treatment Fights Liver Cancer : Researchers See Slowing of Fatal Disease for 73% in Study

WASHINGTON — A new treatment for a primary liver cancer that does not cure the fatal disease but has slowed its progression--with “remarkable responses” in two patients--was reported Tuesday by researchers from UC San Francisco.

The treatment, called chemoembolization , combines chemotherapy with tiny “beads” that are injected into the hepatic artery, the major blood vessel to the liver. The “beads” dam the artery and cut off the blood supply to the tumor, allowing the drugs to be in contact with the cancer longer than was possible with previous methods.

Until recently, “the problem has been that it is hard to get the chemotherapy directly to the tumor,” Dr. Alan Venook, director of the UCSF Liver Tumor Treatment Group, said in New Orleans as he presented his findings to the annual meeting of the American Society of Clinical Oncology.

“The patients are always very sick, and it is difficult to perform the surgery necessary to implant a pump which is used to deliver the medication,” he said in a statement.

‘Remarkable Improvement’

Venook said the treatment is “better than anything else around. Some patients have shown remarkable improvement, but the therapy needs further development.”

The researchers treated 40 patients and reported results on the first 30 cases. One patient remained tumor-free for 16 months and a second for more than two years, they said. Patients with this type of cancer live an average of about eight months after diagnosis.

Overall, 42% of the patients studied showed a partial response to the therapy in which the tumor was reduced by at least half, and in another 31% tumor growth was arrested, the researchers said.

“This is a total of 73% that had some response to the treatment,” Venook said.

The disease, hepatocellular carcinoma , is a primary cancer, which means it originates in the liver rather than spreading to it from another organ. In the United States it strikes about 4,000 people each year, but it occurs far more frequently in Asia and Africa, where other liver diseases such as hepatitis and cirrhosis are also common.

Common Liver Cancer

Worldwide it is the most common of primary liver cancers, which total about 260,000 cases annually, according to World Health Organization figures.

Venook said that hepatocellular carcinoma is expected to become more common in this country with the influx of immigrants from Asia.

“It is very rare that we can cure a person with this kind of cancer,” he said. “We can only remove these cancers surgically about 5% of the time, when we can catch them early enough.”

The chemoembolization technique combines several drugs with tiny particles of harmless starch that are, in a sense, “biodegradable,” the researchers said. After a few days, they said, the starch is absorbed by the body and normal blood flow through the hepatic artery resumes.

Two Blood Lines

Venook said that malignant tumors shrink when their blood supply is cut off, but that such a process would be impossible with other organs because they require a constant blood flow.

The liver alone, he said, has two sources of blood, the hepatic artery--the organ’s main source of support--and the portal vein, which delivers blood containing nutrients and wastes to be processed. These enable the liver to continue to cleanse the blood and aid digestion, Venook said.

During the brief time when the hepatic artery is blocked, the portal vein supplies enough blood to sustain the liver but not enough to nurture the tumor, UCSF officials said.