Megestrol acetate in unresectable hepatocellular carcinoma

Aims and background: No consolidated medical treatment has yet been established for unresectable hepatocellular carcinoma (HCC). A possible interference of hormones in the pathogenesis and cellular growth of HCC has been suggested. Methods: To evaluate the activity and tolerance of progestins in HCC, patients were treated with megestrol acetate orally at a dose of 160 mg daily until progression of disease or grade III-IV toxicity was observed. Results: Eleven patients entered the study and were assessable for response and side effects. Median duration of treatment was 80 days (range 60-150). No major responses were observed, 4 patients had stabilization of disease for at least 2 months, and 7 had progressive disease. Median time to disease progression was 3 months (range 2-5). Three patients required interruption of treatment because of toxicity (2 patients had worsening of concomitant diabetes and 1 patient had gastric bleeding). Conclusions: The results of the present study suggest that hormone therapy with megestrol acetate has no significant role in HCC.