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BY-NC-ND 3.0 license Open Access Published by De Gruyter Open Access February 13, 2014

Adverse reaction of a combined treatment for unresectable liver cancer

  • Jianjun Ren EMAIL logo , Tao Jiang and Rui Peng
From the journal Open Medicine


To investigate the adverse reactions of transcatheter arterial chemoembolization (TACE) combined with trastuzumab in the treatment of unresectable live cancer, 85 unresectable liver cancer patients were treated with 35 mg epirubicin, with lipiodol and gelatin sponge granule as the embolic agent, and trastuzumab (4mg/kg) was administered intravenously. All the adverse reactions were investigated by blood routine examination and the checking of liver, renal and thyroid functions on the postoperative 2nd and 30th day. No patients died of direct medication. The main adverse reactions included haematological toxicity, liver function lesion and postoperative syndromes such as nausea, vomiting, fever and liver area aching. Two days after the treatment, the amount of the serum total bilirubin (TB) and white blood cell (WBC) increased dramatically, while platelet (PLT) changed a little, and creatinine (Cr) and blood urea nitrogen (BUN) did not change at all. Thirty days after the treatment, blood routine, liver and renal functions were examined, demonstrating that the liver function remained unchanged, PLT decreased apparently, WBC was lower, and Cr and BUN changed slightly compared to those before the treatment. The combined treatment is safe for unresectable liver cancer and thus can be used as a routine intervention method.

[1] Namboodiri A.M., Pandey J.P., Differential inhibition of trastuzumab- and cetuximab-induced cytotoxicity of cancer cells by immunoglobulin G1 expressing different GM allotypes, Clin. Exp. Immunol., 2011, 166, 361–365 in Google Scholar PubMed PubMed Central

[2] Kostyal D., Welt R.S., Danko J., Shay T., Lanning C., Horton K., et al., Trastuzumab and lapatinib modulation of HER2 tyrosine/threonine phosphorylation and cell signaling, Med. Oncol., 2012, 29, 1486–1494 in Google Scholar PubMed

[3] Sawaki M., Mukai H., Tokudome N., Nakayama T., Taira N., Mizuno T., et al., Safety of adjuvant trastuzumab for HER-2-overexpressing elderly breast cancer patients: a multicenter cohort study, Breast Cancer, 2012, 19, 253–258 in Google Scholar PubMed

[4] Abe H., Umeda T., Kawai Y., Tanaka M., Mori T., Cho H., et al., [Adjuvant trastuzumab can be infused safely over 30 minutes], Gan To Kagaku Ryoho, 2010, 37, 1887–1891 Search in Google Scholar

[5] Fujita T., Doihara H., Kawasaki K., Takabatake D., Takahashi H., Washio K., et al., PTEN activity could be a predictive marker of trastuzumab efficacy in the treatment of ErbB2-overexpressing breast cancer, Br. J. Cancer, 2006, 94, 247–252 in Google Scholar PubMed PubMed Central

[6] Perez E.A., Jenkins R.B., Dueck A.C., Wiktor A.E., Bedroske P.P., Anderson S.K., et al., C-MYC alterations and association with patient outcome in early-stage HER2-positive breast cancer from the north central cancer treatment group N9831 adjuvant trastuzumab trial, J. Clin. Oncol., 2011, 29, 651–659 in Google Scholar PubMed PubMed Central

[7] Esteva F.J., Guo H., Zhang S., Santa-Maria C., Stone S., Lanchbury J.S., et al., PTEN, PIK3CA, p-AKT, and p-p70S6K status: association with trastuzumab response and survival in patients with HER2-positive metastatic breast cancer, Am. J. Pathol., 2010, 177, 1647–1656 in Google Scholar PubMed PubMed Central

[8] Todeschini P., Cocco E., Bellone S., Varughese J., Lin K., Carrara L., et al., Her2/neu extracellular domain shedding in uterine serous carcinoma: implications for immunotherapy with trastuzumab, Br. J. Cancer, 2011, 105, 1176–1182 in Google Scholar PubMed PubMed Central

[9] Nagahisa Y., Imai S., Yamaguchi K., Okabe M., Tsuruta A., Kawamoto K., et al., [A case of liver metastasis of breast cancer responding to trastuzumab plus weekly paclitaxel chemotherapy maintaining CR for 30 months], Gan To Kagaku Ryoho, 2007, 34, 1501–1503 Search in Google Scholar

[10] Horiguchi J., Oyama T., Takata D., Rokutanda N., Nagaoka R., Odawara H., et al., Pathological complete response and prognosis in patients receiving neoadjuvant paclitaxel and trastuzumab with and without anthracyclines for stage II and III, HER2-positive operable breast cancer: a single-institute experience, Anticancer Res., 2011, 31, 3041–3046 Search in Google Scholar

[11] Takahashi T., Kochi M., Kanamori N., Kaiga T., Funada T., Fujii M., et al., [Complete remission with FLEP chemotherapy for multiple liver metastasis from alpha-fetoprotein-producing gastric cancer-report of a case], Gan To Kagaku Ryoho, 2009, 36, 1885–1888 Search in Google Scholar

[12] Yao Y., [Effects of Feiji decoction for soothing the liver combined with psychotherapy on quality of life in primary lung cancer patients], Zhongguo Fei Ai Za Zhi, 2012, 15, 27–33 Search in Google Scholar

[13] Tada A., Ogawa M., Inagaki J., Horikoshi N., Inoue K., Yamazaki H., et al., [Arterial infusion of combination chemotherapy consisting of adriamycin and mitomycin C for liver metastases of breast cancer], Gan To Kagaku Ryoho, 1986, 13, 70–74 Search in Google Scholar

[14] Osako T., Ito Y., Takahashi S., Tokudome N., Iwase T., Hatake K., Efficacy and safety of trastuzumab plus capecitabine in heavily pretreated patients with HER2-positive metastatic breast cancer, Cancer Chemother. Pharmacol., 2008, 62, 159–164 in Google Scholar PubMed

[15] Kimura M., Tominaga T., Outstanding problems with response evaluation criteria in solid tumors (RECIST) in breast cancer, Breast Cancer, 2002, 9, 153–159 in Google Scholar PubMed

[16] Pectasides D., Pectasides E., Maintenance or consolidation therapy in advanced ovarian cancer, Oncology, 2006, 70, 315–324 in Google Scholar PubMed

[17] Zak Y., Rhoads K.F., Visser B.C., Predictors of surgical intervention for hepatocellular carcinoma: race, socioeconomic status, and hospital type, Arch. Surg., 2011, 146, 778–784 in Google Scholar PubMed

[18] Li B., Yu J., Wang L., Li C., Zhou T., Zhai L., Xing L., Study of local three-dimensional conformal radiotherapy combined with transcatheter arterial chemoembolization for patients with stage III hepatocellular carcinoma, Am. J. Clin. Oncol., 2003, 26, e92–99 10.1097/01.COC.0000077936.97997.ABSearch in Google Scholar PubMed

[19] Sahara S., Kawai N., Sato M., Tanaka T., Ikoma A., Nakata K., et al., Prospective Evaluation of Transcatheter Arterial Chemoembolization (TACE) with Multiple Anti-Cancer Drugs (Epirubicin, Cisplatin, Mitomycin C, 5-Fluorouracil) Compared with TACE with Epirubicin for Treatment of Hepatocellular Carcinoma, Cardiovasc. Intervent. Radiol., 2012, doi: 10.1007/s00270-012-0352-x 10.1007/s00270-012-0352-xSearch in Google Scholar PubMed

[20] Chen S., Li B., Xie H., Xu L., Niu G., Fan K., et al., Phase I clinical trial of targeted therapy using 131I-Hepama-1 mAb in patients with hepatocellular carcinoma, Cancer Biother. Radiopharm., 2004, 19, 589–600 in Google Scholar PubMed

[21] Wang S.E., Xiang B., Guix M., Olivares M.G., Parker J., Chung C.H., et al., Transforming growth factor beta engages TACE and ErbB3 to activate phosphatidylinositol-3 kinase/Akt in ErbB2-overexpressing breast cancer and desensitizes cells to trastuzumab, Mol. Cell Biol., 2008, 28, 5605–5620 in Google Scholar PubMed PubMed Central

[22] Yamaguchi K., Chijiiwa K., Torato N., Kinoshita M., Tanaka M., Ki-ras codon 12 point and P53 mutations: a molecular examination of the main tumor, liver, portal vein, peripheral arterial blood and para-aortic lymph node in pancreatic cancer, Am. J. Gastroenterol., 2000, 95, 1939–1945 in Google Scholar PubMed

[23] Le Brun-Ly V., Martin J., Venat-Bouvet L., Darodes N., Labourey J.L., Genet D., et al., Cardiac toxicity with capecitabine, vinorelbine and trastuzumab therapy: case report and review of fluoropyrimidinerelated cardiotoxicity, Oncology, 2009, 76, 322–325 10.1159/000209336Search in Google Scholar PubMed

[24] Ritter C.O., Wartenberg M., Mottok A., Steger U., Goltz J.P., Hahn D., et al., Spontaneous liver rupture after treatment with drug-eluting beads, Cardiovasc. Intervent. Radiol., 2012, 35, 198–202 in Google Scholar PubMed

[25] Fromigue J., De Baere T., Baudin E., Dromain C., Leboulleux S., Schlumberger M., Chemoembolization for liver metastases from medullary thyroid carcinoma, J. Clin. Endocrinol. Metab., 2006, 91, 2496–2499 in Google Scholar PubMed

[26] Ruszniewski P., O’Toole D., Ablative therapies for liver metastases of gastroenteropancreatic endocrine tumors, Neuroendocrinology, 2004, 80(Suppl 1), 74–78 in Google Scholar PubMed

[27] Tu C.M., Chu K.M., Yang S.P., Cheng S.M., Wang W.B., Trastuzumab (Herceptin)-associated cardiomyopathy presented as new onset of complete left bundle-branch block mimicking acute coronary syndrome: a case report and literature review, Am. J. Emerg. Med., 2009, 27, e901–903 10.1016/j.ajem.2008.11.012Search in Google Scholar PubMed

[28] Yan X., Morgan J.P., Neuregulin1 as novel therapy for heart failure, Curr. Pharm. Des., 2011, 17, 1808–1817 in Google Scholar PubMed

[29] Peltier M., Houpe D., Cohen-Solal A., Beguin M., Levy F., Tribouilloy C., Treatment practices in heart failure with preserved left ventricular ejection fraction: a prospective observational study, Int. J. Cardiol., 2007, 118, 363–369 in Google Scholar PubMed

Published Online: 2014-2-13
Published in Print: 2014-4-1

© 2014 Versita Warsaw

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

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