Abstract

Hepatocellular carcinoma (HCC) represents the third cause of cancer-related death. Because HCC is multicentric with time, excluding the few transplanted patients, sooner or later it becomes untreatable with loco-regional therapies and, until some years ago, it was not responsive to systemic therapies. In 2005 a randomized trial indicated the efficacy of a product containing stem cell differentiation stage factors (SCDSF) taken from zebra fish embryos during the stage in which the totipotent stem cells are differentiating into the pluripotent adult stem cells. In such a trial the patients, with “intermediate” and “advanced” HCC according to BCLC/AASLD guidelines, presented benefit in terms of performance status (PS) and objective tumoral response, with some cases (2.4%) of complete response (CR). The aim of this cohort study is to report the experience of a tertiary referral center on the evidence of cases of CR in patients with “advanced” stage HCC treated with SCDSF as supportive care. CR was regarded as sustained disappearance of the neoplastic areas or blood supply therein, accompanied by normalization of AFP levels. Out of 49 patients consecutively recruited and retrospectively evaluated, 38 had “advanced” stage and 11 “terminal” stage. In 5 patients with “advanced” stage a sustained CR was reported (13.1%). Improvement on PS was obtained in 17 patients (34.6%). No side effects occurred. SCDSF treatment confirmed its efficacy in patients with “advanced” HCC, in terms of PS and tumoral response.

Keywords: Hepatocellular carcinoma, advanced stage, systemic therapy, stem cells, biological response modifiers, sorafenib, targeted molecular therapy, stem cell differentiation stage factors (SCDSF), zebra fish embryos, perform-ance status, complete response, tumoral response, cirrhosis, transplantation, trans-arterial chemoembolization, systemic treatment, randomized controlled trial (RCT), hepatic resection, percutaneous ablation, intra-arterial therapies, computed tomography (CT), alpha-fetoprotein, hepatology, serum HCV antibodies, hepatitis B virus surface, thrombosis, vena cava, bilateral lung me-tastases, necrosis, neoplastic tissue, hepatic nodule, loco-regional, phylogeny, neoplastic hypervascularization, neoangiogenesis reduction, neoplastic foci, sunitinib, Flt-3 receptor, tyrosine kinases