Gut Liver.
2013 Nov;7(6):696-703.
Practical Effect of Sorafenib Monotherapy on Advanced Hepatocellular Carcinoma and Portal Vein Tumor Thrombosis
- Affiliations
-
- 1Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea. jyjang@schmc.ac.kr
- 2Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
- 3Division of Gastroenterology, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
- 4Division of Oncology, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
- 5Department of Radiology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Abstract
- BACKGROUND/AIMS
We investigated the effects of sorafenib monotherapy on advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in a clinical setting.
METHODS
In total, 143 consecutive patients with unresectable HCC were treated with sorafenib. Among these patients, 30 patients with advanced HCC and PVTT (Vp3 or 4) were treated with sorafenib monotherapy.
RESULTS
All patients had a performance status of 1 to 2 (Eastern Cooperative Oncology Group 1/2, 20/10) and Child-Pugh class A or B (A/B, 17/13). Eleven patients had modified Union for International Cancer Control stage IVA tumors, whereas 19 had stage IVB tumors. All patients had PVTT (Vp3, 6; Vp4, 24). Following sorafenib monotherapy, three patients (10.0%) had a partial response with PVTT revascularization, and nine (30.0%) had stable disease, with a disease control rate of 33.3%. The median overall survival was 3.1 months (95% confidence interval [CI], 2.70 to 3.50), and the median progression-free survival was 2.0 months (95% CI, 1.96 to 2.05). Fatigue and hand-foot skin reactions were the most troublesome side effects.
CONCLUSIONS
A limited proportion of patients with advanced HCC and PVTT exhibited a remarkable outcome after sorafenib monotherapy, although the treatment results in this type of patient is extremely poor. Further studies to predict good responders to personalized therapy are warranted.
Keyword
MeSH Terms
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Adult
Aged
Aged, 80 and over
Anorexia/chemically induced
Antineoplastic Agents/adverse effects/*therapeutic use
Carcinoma, Hepatocellular/*drug therapy/pathology
Diarrhea/chemically induced
Disease-Free Survival
Fatigue/chemically induced
Female
Hand-Foot Syndrome/etiology
Humans
Kaplan-Meier Estimate
Liver Neoplasms/*drug therapy/pathology
Magnetic Resonance Imaging
Male
Middle Aged
Nausea/chemically induced
Neoplasm Invasiveness
Niacinamide/adverse effects/*analogs & derivatives/therapeutic use
Phenylurea Compounds/adverse effects/*therapeutic use
Portal Vein/*pathology
Proportional Hazards Models
Tomography, Spiral Computed
Venous Thrombosis/*drug therapy/pathology
Antineoplastic Agents
Phenylurea Compounds
Niacinamide
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