Fucoidan Improves Tumour Control and Liver Function in TACE for Unresectable Hepatocellular Carcinoma: A Randomised Trial

Background

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality. Transarterial chemoembolization (TACE) is the standard locoregional therapy for unresectable HCC but is limited by high recurrence and hepatic toxicity. Low-molecular-weight fucoidan (LMF), a sulfated polysaccharide from brown seaweed, has anticancer and hepatoprotective properties. This study assessed whether LMF enhances tumour response and preserves liver function when combined with TACE.

Methods

In this randomised, double-blind, placebo-controlled trial, 82 patients with unresectable HCC were randomly assigned (1:1) to receive LMF (4.4 g twice daily) or placebo for 6 months in addition to TACE. Tumour response was assessed using modified RECIST criteria, and liver function was monitored via Child–Pugh classification. The primary endpoint was disease control rate (DCR), with objective response rate (ORR), liver function and adverse events as secondary endpoints.

Results

Baseline characteristics were well balanced. DCR was significantly higher in the LMF group (95.24% vs. 80.00%, p = 0.035), with a lower progressive disease rate (4.76% vs. 20.00%). ORR was higher in the LMF group (52.38% vs. 35.00%) but not statistically significant (p = 0.1129). LMF preserved liver function (p = 0.029), with more patients maintaining Child–Pugh Class A (80.95% vs. 62.50%). Adverse event rates were similar, and no severe adverse events occurred.

Conclusions

LMF improved tumour control, preserved liver function and had a favourable safety profile. These findings suggest LMF may mitigate TACE-related hepatic toxicity and prolong treatment eligibility, warranting further validation in larger trials.