Phase II study of flutamide in the treatment of hepatocellular carcinoma

epatocellular carcinoma (HCC) is one of the most common cancers H in Taiwan and in the world.',' The overall prognosis of HCC is very poor. Surgical resection is the only potentially curative treatment for HCC and is most effective for small turn or^.^-^ Unfortunately, many HCC patients have tumor recurrence after surgery and most patients are not eligible for surgery because of advanced stage at presentation. Other treatments, such as conventional radiotherapy"' or chemotherapy,*-'O are ineffective and the results unsatisfactory. Embolization for HCC may be palliative.'' Most of these treatments may have significant side effects. New, effective, and less toxic methods of treatment for patients with advanced HCC are urgently needed. HCC may be a hormone-dependent tumor and hormonal therapy has been recommended for further clinical investigations by several HCC may be an androgen-dependent tumor. Patients with aplastic anemia who developed HCC after long term therapy with androgenic steroids were first reported by Johnson et al." Thereafter, many androgeninduced HCCs were reported.16-" HCC was strongly associated with androgen in vitro and in vivo. Several rat hepatoma cell lines were reported to be androgen-dependent and contained cytoplastic androgen receptors IAR)." Androgen stimulates the growth of HCC cells implantated in rats when compared with controls.20 AR were positive in 74% of male and 33% of female HCC patients.''~22 Androgen may interact with AR of human HCC and enhance tumor growth and invasiveness. The recurrence rates