Although numerous treatment modalities have been explored in patients with advanced hepatocellular carcinoma, the therapeutic options are still limited.
Somatostatin has been shown to have antimitotic activity in endocrine as well as in a variety of nonendocrine tumors.
Expression of somatostatin receptors is found in hepatocellular carcinoma, but the efficacy of the somatostatin analogue octreotide remains controversial.
Dr Hubert Erich Blum and colleagues from Germany conducted a randomized double-blind placebo-controlled multicenter trial.
The investigative team assessed the efficacy of long-acting octreotide for the treatment of advanced hepatocellular carcinoma in 121 untreated patients.
The team randomized patients to either long-acting octreotide intramuscularly every 4 weeks or placebo.
|6-month survival rates were 41% with octreotide vs 42% for controls|
The study groups were comparable with respect to clinical characteristics.
The investigators found no difference in the cumulative survival.
The median survival time was just under 5 months in the octreotide group compared with just over 5 months in the control group.
The team noted that the 6-month survival rates were 41% for octreotide patients, and 42% for control patients, respectively.
The investigators observed that the unadjusted relative risk for mortality in the octreotide group compared with patients in the control group was 1.1.
When adjusted for Okuda, Child-Turcotte-Pugh, and Cancer of the Liver Italian Program scores, the relative risk for octreotide did not change markedly.
The team reported that the Cancer of the Liver Italian Program score appeared to predict survival better than both Okuda and Child-Turcotte-Pugh score.
Dr Blum's team concludes, “Our trial shows no survival benefit for hepatocellular carcinoma patients treated with long-acting octreotide compared with placebo.”