Abstract

BackgroundThis study aimed to investigate the safety of sorafenib for the treatment of unresectable hepatocellular carcinoma in Chinese patients.MethodsA subgroup of 345 Chinese patients from the international database of the Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib (GIDEON) study was included in this analysis. Safety assessment measures were adverse events (AEs) and serious adverse events (SAEs) graded using the National Cancer Institute Common Terminology Criteria version 3.0.ResultsOf 331 evaluable patients, 98% started sorafenib at 800 mg/day. The median treatment duration was 22 weeks (range, 0.1–116 weeks), and median overall survival (OS) was 322 days (10.7 months). Approximately 50% of patients had at least one adverse event, and 6% had grade 3–4 adverse events. Drug-related adverse events were experienced by 29% of patients, and 3.6% had grade 3–4 drug-related adverse events. Overall, 23% of patients (n = 77) experienced serious adverse events, among which only 1 event was drug-related (0.3%). No differences in overall adverse events, serious adverse events, and deaths were observed between Child-Pugh A and Child-Pugh B patients. The most frequent drug-related adverse events were dermatological/skin (24%), hand-foot skin reaction (20%), gastrointestinal (11%), and diarrhea (11%). The majority of adverse events occurred within 30 days of beginning sorafenib.ConclusionSorafenib has satisfactory efficacy and safety in Chinese Child-Pugh A and B patients with unresectable HCC using the recommended dosage of 800 mg/day, and the safety of sorafenib is not affected by liver function. Prophylaxis for gastrointestinal adverse events may help to decrease dose interruptions or discontinuation.Trial registrationClinicalTrials.gov; Identifier: NCT00812175. Date of registration: December 19, 2008.

Highlights

  • This study aimed to investigate the safety of sorafenib for the treatment of unresectable hepatocellular carcinoma in Chinese patients

  • The Sorafenib Hepatocellular Carcinoma Assessment Randomised Protocol (SHARP) trial, an international, multi-centered, phase III placebo-controlled study of 602 patients with advanced Hepatocellular carcinoma (HCC), found that sorafenib significantly prolonged survival in patients with unresectable HCC, with an overall survival of 10.7 months compared to 7.9 months for placebo, with an acceptable safety profile [13]

  • 89% had hepatitis B infection, 33% had more than three liver lesions, 43% had HCC confined to the liver, 40.5% had extrahepatic HCC, 30% had portal vein thrombosis, and 22% had vascular invasion

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Summary

Introduction

This study aimed to investigate the safety of sorafenib for the treatment of unresectable hepatocellular carcinoma in Chinese patients. While TACE may provide a meaningful increase in overall survival (OS) for some patients with intermediate (unresectable) disease, many patients in the Asia-Pacific region present with advanced HCC for which most therapies do not provide a meaningful increase in OS [6]. The Sorafenib Hepatocellular Carcinoma Assessment Randomised Protocol (SHARP) trial, an international, multi-centered, phase III placebo-controlled study of 602 patients with advanced HCC, found that sorafenib significantly prolonged survival in patients with unresectable HCC, with an overall survival of 10.7 months compared to 7.9 months for placebo, with an acceptable safety profile [13]. The 2009 Asia-Pacific (AP) study showed that sorafenib was well tolerated and demonstrated a significant improvement in OS over placebo in the treatment of HCC in Asian patients [14]

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