Complete, Durable Remission of Advanced Hepatocellular Carcinoma Under Treatment with Viscum Album Extracts – A Case Report

Abstract

Background: Hepatocellular carcinoma (HCC) is the 3rd leading cause of cancer deaths worldwide. Early stage disease is treated with surgery or transplantation with curative intent, but most patients present with advanced HCC, which carries a poor prognosis. Even with palliative systemic treatment – typically a kinase inhibitor – advanced HCC carries a life expectancy of a year or less. Viscum album extracts (VAE) are used by cancer patients as an adjunct for cancer treatment or palliation. Case Summary: A 51-year old female with a 30-year history of hepatitis C virus infection, presented with relapsing multifocal hepatocellular cancer, stage C in the Barcelona Clinic Liver Cancer staging system, following primary resection of a single lesion 3 months earlier. She declined palliative treatment and commenced intravenous application of VAE. The intravenous VAE treatment was given in conjunction with intravenous hepato-protective L-ornithine L-aspartate (LOLA). Under this treatment she experienced a significant improvement of life-quality and performance status. Three months later a significant regression was noted on computerised tomography scanning and her tumour marker (α-foetoprotein) was in normal reference range, where it remains to date. Further imaging 11 months later confirmed a complete regression. The subcutaneous and intravenous VAE, as well as LOLA treatment continues to date. The regression is sustained for 31/2 years at publication, confirmed by regular imaging and serology. The patient is experiencing an excellent, unrestricted quality of life. The patient had no other cancer-directed therapy and no treatment of her hepatitis C infection. Conclusion: Complete regression of advanced HCC is rare, spontaneous regression is even rarer. Disease responses to VAE treatment of HCC have been reported before. However, this is the first documented case with a complete and durable regression of an HCC under treatment with VAE. Further studies should evaluate benefits of VAE treatment in HCC, especially when administered in forms as reported here.