Survival was not significantly affected by liver metastasis when selleckchem imatinib mesylate was warranted. Background Hepatocellular carcinoma represents the third leading cause of cancer related death worldwide. Only a minority of patients is eligible for potential curative treat ments such as surgical resection, liver transplantation and local ablative therapies. Therapeutic options for patients with advanced HCC are limited. So far, Sorafenib, a multi targeted tyrosine kinase inhibitor, is the only drug, which leads to an increase in overall sur vival in patients with advanced HCC as demonstrated in two randomized phase III placebo controlled trials.

Sorafenib delays tumor progression but as it does not achieve tumor resolution and tumor free long term sur vival there is major need to develop new options that would further increase the current therapeutic benefits, Therefore, new treatment options are urgently needed for patients with HCC at several phases of their evolution and recommendations regarding the optimal trial Inhibitors,Modulators,Libraries designs have been published. Immunotherapy represents a potentially attractive option for HCC patients. Cancer vaccines using pep tides derived from tumor specific antigens represent one potential alternative immunotherapeutic procedure. A number of different tumor antigens identified in HCC represent potential antigens for a peptide based vaccina tion approach in patients with HCC. Telomerase activity has been expressed in numerous tumors includ ing HCC and immunogenic telomerase peptides have been characterized.

Inhibitors,Modulators,Libraries Recently, it has also been reported that telomerase specific CD4 and CD8 T cell responses are induced upon vaccination Inhibitors,Modulators,Libraries with hTERT transfected dendritic cells and vaccination with telomerase derived peptide, GV1001, was shown to induce T cell responses in patients with non resectable pancreatic cancer and non small cell lung cancer. However, the effect of a cancer vaccine might be inhib ited by the presence of CD4 CD25 regulatory T cells, which are known to suppress the function of anti gen specific T cell responses and are increased in patients with HCC. Previously, we have been able to demonstrate that low dose cyclophosphamide treatment can impair the effect of regulatory Inhibitors,Modulators,Libraries T cells in patients with HCC. Based on these studies we have now investi gated the effect of a telomerase peptide cancer vaccine in combination with a low dose cyclophosph amide treatment. Methods Patient population Inhibitors,Modulators,Libraries The study population consisted of male or female patients Lapatinib with advanced stage hepato cellular carcinoma, which was either confirmed histologi cally or diagnosed according to European Association for the Study of the Liver criteria of known predisposing chronic liver disease, alpha fetoprotein 400 ng mL, and characteristic imaging.