Abstract

ABSTRACT Background GIDEON (NCT00812175) is an ongoing, global, prospective, non-interventional study of patients with unresectable hepatocellular carcinoma (HCC) receiving sorafenib (Nexavar®) in real-life practice. The aim is to evaluate sorafenib safety and efficacy in diverse settings and patient groups. The second interim analysis was triggered when ∼1500 patients had been treated for ≥ 4 months. We describe sorafenib use in Europe according to disease stage. Methods Patient/disease characteristics (including Barcelona Clinic Liver Cancer [BCLC], tumour node metastases [TNM], Cancer for the Liver Italian Programme [CLIP]) and treatment history were recorded at enrolment; sorafenib dose, concomitant medications, performance status, liver function, adverse events (AEs) and efficacy are recorded at follow-up visits. Results Of 1571 patients in the safety population, 588 are in Europe (see table). The majority of patients were BCLC-C (52.9%), TNM III (40.3%) or CLIP 1/2 (26.0%/25.9%), although sorafenib was also used in patients with early, intermediate and end-stage disease. Generally, AEs and serious AEs (SAEs) increased with advancing disease (AEs: 66.0%, 87.4%, 85.5%, 89.7%; SAEs: 22.6%, 37.8%, 38.3%, 58.6%; for BCLC-A, B, C and D; respectively), whereas sorafenib-related AEs and SAEs were comparable across BCLC groups (AEs: 60.4%, 74.1%, 68.5%, 41.4%; SAEs: 7.5%, 15.4%, 10.3%, 10.3%; for BCLC-A, B, C and D; respectively). Evaluation will continue with more mature data. Medical oncologist (n = 189) Hepatologist/ GI specialist (n = 332) EU total (n = 588) BCLC stage at study entry, % of n A 6.9 8.7 9.0 B 19.6 27.7 24.3 C 59.3 50.6 52.9 D 3.2 5.4 4.9 NE/missing 11.1 7.5 8.8 TNM stage at study entry, % of n I 3.2 10.5 8.8 II 8.5 12.3 10.2 III 39.2 41.9 40.3 IV 40.2 19.9 26.9 NE/missing 9.0 15.4 13.8 Child-Pugh score at start of sorafenib therapy, % of n A 68.3 64.8 66.3 B 13.8 26.8 21.6 C 1.1 1.8 1.5 NE/missing 16.9 6.6 10.5 CLIP score at start of sorafenib therapy, % of n 0 14.8 8.4 11.9 1 24.3 26.5 26.0 2 24.3 26.5 25.9 3 5.8 15.7 11.4 4–6 4.2 11.4 8.7 NE/missing 26.5 11.4 16.2 NE, not evaluable Conclusions These data reflect real-world sorafenib given to a broad range of patients, indicating a similar safety profile across the different disease stages. Evaluation is ongoing, with more mature data expected from the final analysis. Disclosure B. Daniele: Dr B. Daniele has participated in advisory boards and received lecture fees from Bayer. J. Turnes: Dr J Turnes has participated in advisory boards for Roche Pharma. C. Papandreou: Prof. C Papandreou has participated in advisory boards for Bayer, Sanofi Aventis, Novartis, Bristol Meyers Squibb and Janssen. P. Stal: Prof. Stal has advised and received a grant from Bayer. A. Croitoru: Dr A Croitoru has consulted for and received an investigator fee from Bayer. P: Mathurin: Dr. P . Mathurin was paid speaking at symposia for Roche, Schering-Plough, Gilead Sciences, Bristol-Myers Squibb, Janssen-Cilag and Bayer Healthcare pharmaceutical companies. He is an investigator for Roche, Schering-Plough, Bristol-Myers Squibb, Gilead Sciences, Vertex pharmaceuticals Janssen-Cilag, Boeringher, Novartis and Bayer Healthcare companies. He is a member of the French boards of experts in Hepatology for Roche Schering-Plough, Gilead Sciences, Bayer Healthcare and Bristol-Myers Squibb pharmaceutical companies. He is consulting for the Gilead Sciences, Bristol-Myers Squibb, Bayer Healthcare and Vertex pharmaceutical Companies. All other authors have declared no conflicts of interest.

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