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. 2017 Jun 5;8(35):59991-59998.
doi: 10.18632/oncotarget.19000. eCollection 2017 Aug 29.

Liver cancers with stem/progenitor-cell features - a rare chemotherapy-sensitive malignancy

Bruno Christian Köhler  1   2 , Nina Waldburger  3   2 , Kai Schlamp  4 , Dirk Jäger  1   2 , Karl Heinz Weiss  5   2 , Henning Schulze-Bergkamen  6 , Peter Schirmacher  3   2 , Christoph Springfeld  1   2
Affiliations

Liver cancers with stem/progenitor-cell features - a rare chemotherapy-sensitive malignancy

Bruno Christian Köhler et al. Oncotarget. .

Abstract

Primary liver tumors are a heterogeneous group of malignancies. Besides classical hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC), combined and intermediate forms of liver cancer exist and can express stem-cell markers like nuclear cell adhesion molecule (NCAM-1/CD56), c-kit (CD117) or epithelial cell adhesion molecule (EpCAM) together with high proliferative activity. Liver tumors with progenitor-cell features are associated with an unfavorable prognosis, but the phenotype has not resulted in therapeutic consequences so far. We report three patients with liver cancers with stem/progenitor-cell features that responded exceptionally well to chemotherapy. These encouraging results indicate that the identification of liver cancer with stem/progenitor-cell phenotype in a patient´s tumor might justify an attempt to treat the patient with chemotherapy. Further case studies and finally clinical trials will be necessary to determine the optimal treatment for patients with this rare form of liver cancer.

Keywords: alpha fetoprotein; chemotherapy; liver cancer; liver progenitor cell; liver stem cell.

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Conflict of interest statement

CONFLICTS OF INTEREST There is no conflict of interest.

Figures

Figure 1
Figure 1. Immunohistochemistry for liver cancers with stem/progenitor cell features
Immunohistochemistry of the liver tumor from patient 1 A. Hematoxylin and Eosin Staining B. Ki67 C. Alpha Feto Protein D. EpCAM E. Cytokeratin 7 F. OCH1E5.
Figure 2
Figure 2. Clinical course of patients 1 and 2 including various chemotherapy regimens and AFP
Serum AFP of patient 1 A. and patient 2 B. during treatment. Grey boxes indicate treatment regime. Gem/Cis: Gemcitabine + Cisplatin, Pacli/Ox: Paclitaxel + Oxaliplatin, Gem/nab-P: Gemcitabine + nab-Paclitaxel, Carbo/Gem: Carboplatin/Gemcitabine.
Figure 3
Figure 3. CT-scans reveal a marked response to therapy until the fourth line of treatment (patient 1)
A. CT scan before (left) and after (right) induction of first line poly-chemotherapy according to FOLFOX6 protocol. B. CT scan before (left) and after (right) 4th line chemotherapy according to FOLFIRI protocol. According to RECIST criteria, a partial response with -36 % calculated for all target lesions was achieved.
Figure 4
Figure 4. Response to chemotherapy in patient 3
A. CT scan before (left) and after (right) induction of first-line poly-chemotherapy according to FOLFOX protocol. B. LDH and AFP in serum decline to normal during treatment with 6 cycles FOLFOX.
See this image and copyright information in PMC

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