Adriamycin increased median survival to 10.6 weeks versus 7.5 weeks with no antitumor therapy in inoperable HCC (P=0.036), but caused fatal complications in 25% of patients.
RCT (n=106)
randomized
Does doxorubicin improve survival in patients with inoperable hepatocellular carcinoma?
Although doxorubicin slightly prolonged median survival in inoperable HCC, its clinical utility is severely limited by a 25% rate of fatal complications, including unpredictable cardiotoxicity and septicemia.
Absolute Event Rate: 10.6% vs 7.5%
p-value: p=0.036
To assess the efficacy and safety of Adriamycin (Adria Laboratories, Columbus, OH) in inoperable hepatocellular carcinoma (HCC), 60 patients were randomized to receive Adriamycin 60 to 75 mg/m2 at 3-week intervals and 46 patients to receive no antitumor therapy. The median survival rate of the Adriamycin group was 10.6 weeks; that of the group receiving no antitumor therapy was 7.5 weeks (P = 0.036). Adriamycin induced tumor regression of 25% to 50% in 5% of patients and of over 50% in only 3.3% of patients. It caused fatal complications (septicemia and cardiotoxicity) in 25% of patients. The severity of neutropenia leading to septicemia for a particular dose was unpredictable. Four of eight patients who developed cardiotoxicity received less than 500 mg/m2 of Adriamycin. We conclude that Adriamycin is not an ideal drug for the treatment of inoperable HCC.
Lai et al. (Mon,) conducted a rct in inoperable hepatocellular carcinoma (n=106). Adriamycin vs. no antitumor therapy was evaluated on median survival (weeks) (p=0.036). Adriamycin increased median survival to 10.6 weeks versus 7.5 weeks with no antitumor therapy in inoperable HCC (P=0.036), but caused fatal complications in 25% of patients.
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