Early Efficacy of Sorafenib Therapy in Advanced Hepatocellular Carcinoma

Abstract

Background:We reviewed the early efficacy of sorafenib therapy in advanced hepatocellular carcinoma (HCC). Methods:Subjects comprised a total of 62 patients with advanced HCC undergoing oral chemotherapy with sorafenib at Tokyo Women’s Medical University Hospital from May 2009. The background factors and cumulative survival rates were analyzed statistically and compared between cases deemed unsuitable for continued treatment on or before day 28 and those deemed suitable for continued treatment beyond day 28 of oral chemotherapy with sorafenib. Results:Treatment was discontinued on or before day 28 in 16 (25.8%) and continued beyond day 28 in 46 (74.2%) patients. There were significant differences in Child-Pugh B and C between the discontinued and the continued treatment groups. The cause of discontinuation of treatment was liver dysfunction in 9, anorexia in 2, rash or desquamation in 2, and diarrhea, gastrointestinal bleeding and economic factors in 1 patient each. The response evaluation criteria in solid tumors (RECIST) in the continued treatment group were:CR in 2, PR in 1, SD in 18 and PD in 25 patients. There was a statistically significant difference (p=0.0026) in mean survival rate between the groups, with 91 and 393 days in the discontinued and continued treatment groups, respectively. With regard to the starting dose in the continued treatment group, there was no significant difference in mean survival rate between the 800 mg group and the 400 mg group, with 415 and 308 days, respectively. Conclusion:These results suggest the possibility that oral chemotherapy with sorafenib for advanced HCC is effective if discontinuation in the early stages of treatment is prevented and long-term chemotherapy is achieved.