Author/Authors :
Marinelli, Sara University of Bologna - S Orsola-Malpighi Hospital - Department of Medical and Surgical Sciences, Italy , Granito, Alessandro University of Bologna - Department of Medical and Surgical Sciences - S Orsola-Malpighi Hospital, Italy , Piscaglia, Fabio University of Bologna - S Orsola-Malpighi Hospital - Department of Medical and Surgical Sciences, Italy , Renzulli, Matteo University of Bologna - S Orsola-Malpighi Hospital - Radiology Unit, Italy , Stagni, Angela University of Bologna - S Orsola-Malpighi Hospital - Department of Medical and Surgical Sciences, Italy , Bolondi, Luigi University of Bologna - S Orsola-Malpighi Hospital - Department of Medical and Surgical Sciences, Italy
Abstract :
Introduction: Sorafenib, an oral multikinase inhibitor, is the only systemic agent proven to be effective in patients with hepatocellular carcinoma (HCC). There are no approved second line systemic therapies in patients who have had disease progression on or are not eligible to sorafenib.Case Presentation: We describe two cases of unresectable HCC that were treated with low, metronomic doses of capecitabine. In the first patient, capecitabine was used after sorafenib failure. In the second case, treatment with capecitabine was attempted since the patient was considered not eligible for sorafenib due to spontaneous hepatic bleeding of a large HCC lesion. Treatment was effective and well tolerated in both patients with long-lasting objective responses.Conclusions: Lacking established second-line therapy, metronomic capecitabine may be a valid alternative in the treatment of HCC patients who are judged not eligible for sorafenib or those having progression disease on sorafenib.
