Hepatitis B viral load to predict survival of HCC patients treated with sorafenib.

Abstract

188 Background: Sorafenib demonstrated survival prolongation in patients with advanced hepatocellular carcinoma (HCC). Until now, the effect of HBV DNA titer on prognosis of HCC patients treated with sorafenib has not been determined. Methods: From 2008 to 2012, 78 HBV-related HCC patients who received sorafenib at Severance hospital were included in our analysis. The prognostic effect of pretreatment HBV DNA level was examined by univariate and multivariate analysis. Results: The median overall survival was 5.2 months (95% confidence interval [CI]: 4.0-6.4) and median progression free survival was 3.5 months (95% CI: 2.3–4.7). Multivariate analysis revealed that a high baseline HBV DNA level (>2,000 IU/L) was an independent risk factor for worse overall survival (p=0.005; hazard ratio [HR], 2.85), and rapid disease progression in a subgroup who did not receive antiviral prophylaxis with sorafenib (p=0.008; HR, 87.4). Moreover, viral reactivation occurred more frequently in patients who did not receive prophylactic antiviral therapy with sorafenib compared to those who did (4/38 vs. 0/40; p=0.025). Conclusions: A higher HBV DNA level before sorafenib was associated with poorer prognosis and increased viral reactivation. This result suggests the role of prophylactic antiviral therapy in patients who received sorafenib. [Table: see text]