Sorafenib in hepatocellular carcinoma: efficacy and predictive factors

Abstract

ObjectiveTo evaluate the efficacy and safety in patients with hepatocellular carcinoma treated with sorafenib and determine the predictive factors for survival. MethodsFrom April 2009 to December 2010, all patients with hepatocellular carcinoma treated with sorafenib were included in the study. Clinical data and survival time were collected. Survival analysis was conducted using the Kaplan-Meier method, and predictive factors for survival were analysed using the Cox's model. ResultsA total of 51 patients were included in the study, the median time of follow-up was 10 months (range 1–22). All the 51 patients had one or more adverse events, of which 2 patients died of upper gastrointestinal bleeding and 6 patients discontinued treatment. The mean survival time was 11 months and 1-year survival was 60.8%. On univariate analysis, the median survival time of patients with tumors of BCLC A, B and C were 17, 12.5 and 8.5 months, and 1-year survival were 71.4%, 61.1%, and 23.1%, respectively (P=0.006). Compared with those with mild and poor arterial supply tumors, patients with good arterial supply tumors had longer median survival time (12 months vs 8 months and 9 months) and higher 1-year survival (52.0% vs 30.8% and 38.5%) (P=0.037). Patients with portal invasion had shorter median survival time and lower 1-year survival (8.5 months vs 13 months and 57.6% vs 16.7%, respectively) than those without (P=0.012). Patients with prealbumin ⩾170 mg/L had longer median survival time and higher 1-year survival (13.5 months vs 9 months and 55.6% vs 36.4%, respectively) than those with prealbumin <170 mg/L (P=0.016). Early tumor BCLC staging and high level of prealbumin were independent predictive factors for survival on multivariate analysis using Cox's regression model, the hazard ratio were 3.69 (95%CI: 1.30–10.53, P=0.015) and 3.53 (95%CI: 1.40–8.91, P=0.008) respectively. ConclusionUpper gastrointestinal bleeding was a severe event need to be concerned in patients with hepatocellular carcinoma treated with sorafenib. Patients with high level of prealbumin could benefit more from sorafenib treatment, and prealbumin could be a predictor for survival in HCC patients treated with sorafenib.