Analysis of Sorafenib Outcome: Focusing on the Clinical Course in Patients with Hepatocellular CarcinomaReport as inadecuate




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Background

Treatment outcomes of sorafenib therapy may greatly vary depending not only on tumor spread but also on past clinical processes prior to sorafenib therapy and timing of sorafenib administration in the past clinical course of hepatocellular carcinoma HCC. We evaluated the efficacy of sorafenib in patients with HCC, taking into account of their past clinical courses.

Methods

Patients with HCC treated with sorafenib as a first-line systemic therapy, whose courses documented from the time of the initial diagnosis, were retrospectively analyzed.

Results

Of the 123 patients receiving sorafenib therapy at an advanced-stage, baseline characteristics differed including the rate of hepatitis C virus, Child–Pugh class, and status of intrahepatic lesions according to stage progression processes. Overall survival OS in patients progressed directly from the early-stage 15.3 months was significantly longer than that in patients diagnosed at the advanced-stage 5.3 months, P = 0.022 and progressed from the intermediate-stages 6.0 months, P = 0.041. Of 105 patients diagnosed at the intermediate-stage on past clinical courses, OS of starting sorafenib therapy before progression to the advanced-stage 67 patients was significantly longer than for patients starting sorafenib therapy only after progression to the advanced-stage 38 patients P = 0.015.

Conclusion

Characteristic differences between past stage progression processes might affect prognosis in advanced-stage HCC patients receiving sorafenib. Switching to sorafenib therapy before progression to the advanced-stage appears more effective than that after progression to the advanced-stage in patients diagnosed in the intermediate-stage on past clinical courses prior to sorafenib administration.



Author: Sadahisa Ogasawara, Tetsuhiro Chiba , Yoshihiko Ooka, Eiichiro Suzuki, Masanori Inoue, Toru Wakamatsu, Akinobu Tawada, Osamu Yoko

Source: http://plos.srce.hr/



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