p53 gene therapy for pulmonary metastasis tumor from hepatocellular carcinoma.

The objective of this study is to explore the safety, efficacy, and administration method of the recombinant adenovirus p53 gene (rAd-p53, or gendicine) in the treatment of pulmonary metastasis tumor from advanced hepatocellular carcinoma (HCC). Pulmonary metastasis tumors from HCC in 20 patients were treated by using transcatheter bronchial arterial gendicine infusion combined with transcatheter arterial embolization and intratumor injection of gendicine if the maximal diameter of a metastatic tumor is greater than or equal to 3 cm. Three patients received the combined therapy three times, seven received it twice, and ten received it once. Eighteen patients were followed for 2-12 months after treatment and two patients were lost to follow-up. Spiral computed tomography was performed during follow-up visits to monitor tumor progress. Lung metastasis tumor disappeared in four patients and the tumor size decreased in six patients, remained unchanged in five, and increased in three patients. Overall, the clinical symptoms were alleviated in 16 patients (88.9%) and were exacerbated in two patients. New metastatic lesions were found in eight patients. There were no serious adverse events except for self-limited fever (38 degrees C-39.5 degrees C), which was found in 16 patients. Transcatheter bronchial arterial gendicine infusion combined with transcatheter arterial embolization, with or without intratumor injection of gendicine, is a safe, effective therapy for the treatment of pulmonary metastasis tumor from HCC.