Division of Hepatobiliary Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Department of Internal Medicine, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2021 Jul;37(7):616-623. doi: 10.1002/kjm2.12374. Epub 2021 Mar 3.
Previous in vitro and in vivo experiments had demonstrated dose-dependent anti-cancer effects of clinical plasma colchicine concentrations on hepatocellular carcinoma (HCC) cells. This phase IIa trial was to evaluate the potential efficiency and safety of our novel colchicine dosage schedule for the palliative treatment of advanced HCC. The dosage schedule started from oral intake of 1 mg colchicine three times per day for 4 days and discontinuation in the following 3 days (one cycle). The treatment cycle was repeated and the dosage was adjusted ranging from 3 to 1.5 mg/day according to the condition of the participant. The control group was originated from chart review of 86 HCC patients treated by sorafenib for more than 2 months. Fifteen participants signed the inform consent. Two participants were excluded due to screening failure in one and less than four treatment cycles in another. For severe adverse events, the colchicine group demonstrated higher incidence of biliary tract obstruction (p = 0.0184) than the sorafenib group. Comparison grade 1 or 2 adverse events between two groups, the colchicine group had higher incidence of diarrhea (p = 0) and the sorafenib group had higher incidence of palmar-plantar erythrodysesthesia syndrome (p = 0.0045). There was no significant difference in mortality, median survival, and overall survival between two groups (all p > 0.2). In conclusion, our novel colchicine dosage schedule is clinically feasible and has the potential to be applied in the palliative treatment of advanced HCC especially based on the cost-effectiveness consideration.
先前的体外和体内实验已经证明,临床血浆秋水仙碱浓度对肝细胞癌(HCC)细胞具有剂量依赖性的抗癌作用。本 IIa 期临床试验旨在评估我们新型秋水仙碱剂量方案在晚期 HCC 姑息治疗中的潜在疗效和安全性。该剂量方案起始于口服秋水仙碱 1mg,每日 3 次,连续 4 天,随后停药 3 天(一个周期)。根据患者的情况,重复治疗周期并调整剂量范围为 3 至 1.5mg/天。对照组来源于接受索拉非尼治疗超过 2 个月的 86 例 HCC 患者的病历回顾。15 名参与者签署了知情同意书。由于一名参与者筛选失败,另一名参与者治疗周期少于 4 个,因此两名参与者被排除在外。对于严重不良事件,秋水仙碱组胆道梗阻的发生率(p=0.0184)高于索拉非尼组。比较两组 1 级或 2 级不良事件,秋水仙碱组腹泻发生率较高(p=0),索拉非尼组手足皮肤反应综合征发生率较高(p=0.0045)。两组死亡率、中位生存期和总生存期均无统计学差异(均 p>0.2)。总之,我们的新型秋水仙碱剂量方案在临床上是可行的,并且具有在晚期 HCC 的姑息治疗中应用的潜力,尤其是基于成本效益考虑。