Nooman Gilani

Spontaneous regression of hepatocellular carcinoma is possible and might have implications for future therapies

Hepatocellular carcinoma is a potentially challenging cancer with very high mortality. Medical therapies are generally ineffective in achieving complete remission, especially for aggressive types or for advanced stage cancers. Spontaneous regression of these tumors is a rare and fascinating phenomenon. We describe such a patient with spontaneous regression of a large multi-focal hepatocellular carcinoma, and present a comprehensive review of the reported cases with a special emphasis on potential regression mechanisms.

Utility of SBFT to assess stricturing Crohn disease of small intestine

patients with Crohn’s disease. Methods: This is an ongoing, 16-week randomized, double-blind, placebocontrolled study in patients with Crohn’s disease who are starting therapy with 6-MP. Study subjects are started on 6-MP at a dose of 1.2 mg/kg and, in addition, are randomized to receive either sulfasalazine (SSZ) at a target dose of 4 g/day or an identical appearing placebo. Exclusion criteria include low TPMT enzyme activity, known sulfa allergy, and prior colectomy. Metabolic endpoints (6-MP metabolites, TPMT enzyme activity) and clinical endpoints (quality of life as assessed by IBDQ, Harvey-Bradshaw Index [HBI]) are assessed at weeks 8 and 16. Preliminary week 8 results are presented. Results: To date, 35 patients have met inclusion criteria and started 6-MP with either SSZ or placebo. Of these patients, 19 were withdrawn from the study for the following reasons: allergic reaction to 6-MP (N 9 (26%); 3 on SSZ and 6 on placebo), possible reaction to SSZ (N 6), other reactions (N 2), and non-compliance (N 2). Data for the remaining 16 patients are presented in the table.