Abstract
BackgroundWe investigated the contribution of subsequent therapy for advanced hepatocellular carcinoma refractory or intolerant to sorafenib. Further, we investigated the impact of sorafenib on overall survival using individual data.MethodsWe reviewed the medical records of patients with advanced hepatocellular carcinoma treated with sorafenib. Survival after sorafenib treatment and overall survival were defined as the time when we discovered that patients were either refractory or intolerant to sorafenib and the period from the start of sorafenib treatment, respectively, until death during the study. We compared patients’ prognoses according to their subsequent treatment as follows: group A, therapies targeting intrahepatic lesions; group B, systemic therapies alone; group C, no subsequent therapy. We used linear regression analysis to determine whether there was an association with survival after sorafenib treatment and with overall survival.ResultsOf 79 patients, 63 (79.7 %) received one or more subsequent therapies (44 and 19 patients in groups A and B, respectively). The five patients who survived more than two years after sorafenib treatment was discontinued responded to therapies targeting intrahepatic lesions. The median survival times of groups A, B, and C were 11.9 months, 5.8 months, and 3.6 months, respectively. Multivariate analysis revealed that group A, Child-Pugh score, serum α-fetoprotein level, and cause of failure of sorafenib treatment were independent prognostic factors for survival after sorafenib treatment. Individual survival after sorafenib treatment correlated highly with overall survival.ConclusionsTargeting intrahepatic lesions may be useful for treating patients with advanced hepatocellular carcinoma patients after sorafenib treatment is discontinued.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2380-4) contains supplementary material, which is available to authorized users.
Highlights
We investigated the contribution of subsequent therapy for advanced hepatocellular carcinoma refractory or intolerant to sorafenib
We reviewed patients’ medical records and collected demographic, clinical, and laboratory data including age, sex, Eastern Cooperative Oncology Group performance status, history of viral infection, factors related to hepatic reserve associated with Child-Pugh classification, imaging data, and tumor markers at the time of a refractory response or intolerance to sorafenib
We reviewed retrospectively 99 consecutive patients with advanced Hepatocellular carcinoma (HCC) who were treated with sorafenib monotherapy in our institution between June 2009 and October 2014
Summary
We investigated the contribution of subsequent therapy for advanced hepatocellular carcinoma refractory or intolerant to sorafenib. We investigated the impact of sorafenib on overall survival using individual data. Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related mortality worldwide [1]. The number of patients with HCC who can be treated curatively is limited owing to impaired hepatic reserve and frequent metachronous recurrence to become difficult to treat. The prognosis of patients with advanced HCC remains poor [3]. An orally administered multikinase inhibitor that blocks tumor cell proliferation and angiogenesis, represents the only systemic drug that significantly improves overall survival (OS) of patients with advanced HCC [4]. Sorafenib is recognized as standard first-line therapy for advanced HCC [5, 6]
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