Abstract
Portal hypertension, the most important complication with cirrhosis of the liver, is a serious disease. Sorafenib, a tyrosine kinase inhibitor is validated in advanced hepatocellular carcinoma. Because angiogenesis is a pathological hallmark of portal hypertension, the goal of our study was to determine the effect of sorafenib on portal venous flow and portosystemic collateral circulation in patients receiving sorafenib therapy for advanced hepatocellular carcinoma. Porto-collateral circulations were evaluated using a magnetic resonance technique prior sorafenib therapy, and at day 30. All patients under sorafenib therapy had a decrease in portal venous flow of at least 36%. In contrast, no specific change was observed in the azygos vein or the abdominal aorta. No portal venous flow modification was observed in the control group. Sorafenib is the first anti-angiogenic therapy to demonstrate a beneficial and reversible decrease of portal venous flow among cirrhotic patients.
Highlights
Cirrhosis is a major public health problem, most commonly caused by alcoholism or viral hepatitis
Patient Characteristics Between October 2009 and July 2010, 7 patients with advanced-stage hepatocellular carcinoma (HCC) received sorafenib therapy according to the schedule described above and 9 patients were included in the control group
We report a significant reduction in portal venous flow (54% of mean portal venous flow) in seven patients with advanced HCC receiving sorafenib
Summary
Cirrhosis is a major public health problem, most commonly caused by alcoholism or viral hepatitis. Complications from advanced cirrhosis include hepatocellular carcinoma (HCC) and portal hypertension. One of the underlying causes of cirrhotic portal hypertension is the growth of collateral circulation [2]. In experimental models of portal hypertension, a number of receptor tyrosine kinase inhibitors, including imatinib, sunitinib and sorafenib, have been shown to regulate splanchnic neovascularization and improve portal hypertension [6,7]. Receptor tyrosine kinase inhibitors offer a promising new approach to the management of portal hypertension.[8,9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
