Chemotherapy of Primary Liver Cancer

Abstract

Despite the large number of patients throughout the world who die of primary liver cancer, the number of patients entered on carefully planned clinical trials from which valid conclusions can be drawn remains limited. Uncontrolled clinical trials conducted during the last 30 years have led to a degree of optimism about results that can be obtained with drugs as diverse as alloxan, 5-fluorouracil, and doxorubicin. Prospectively randomized stratified trials continue to show some activity for various agents (or agent combinations) but none of these give a predictable response rate of > 20%, and survival continues to be a function of the patient discriminants rather than be attributable to a specific drug regimen. Response can, however, occasionally be obtained without necessarily causing severe treatment morbidity. It can, therefore, be stated that the disease is not absolutely resistant to treatment by cancer chemotherapy. The response that can be achieved for a group of patients with standard available cancer chemotherapeutic agents or regimens is not, however, good enough. New treatment approaches and new drug trials should be the frontline approach for patients with advanced disease wherever possible.