Efficacy and optimal treatment sequence of Sorafenib and hepatic arterial infusion chemotherapy for advanced hepatocellular carcinoma

Abstract

We examined whether treatment sequence and secondary therapy affected prognosis in advanced hepatocellular carcinoma (HCC) of Child-Pugh A without metastasis. The study included 148 patients: 83 who primarily received Hepatic Arterial Infusion Chemotherapy (HAIC), 53 who received Sorafenib, and 12 with best supportive care (BSC). These treatment groups were stratified by presence (+)/absence (-) of secondary therapy. Although a significant difference in the response rate was found between the HAIC group and the Sorafenib group, there were no differences in disease control rate and survival. Additionally, both prolonged survival compared to the BSC group. Sorafenib (+) group showed the highest cumulative survival rate, which was an independent prognostic factor in multivariate analysis. Furthermore, the initial Sorafenib dose per body weight was a contributing factor for treatability with HAIC as secondary therapy subsequent to Sorafenib. The prognosis of advanced HCC might be improved by Sorafenib per body weight followed by HAIC.