Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jan 22:11:1013-1021.
doi: 10.2147/CMAR.S186678. eCollection 2019.

Implementation of sorafenib treatment for advanced hepatocellular carcinoma: an illustration of current practice in Taiwan

Kun-Ming Chan  1 , Tsung-Han Wu  1 , Chih-Hsien Cheng  1 , Chen-Fang Lee  1 , Ting-Jung Wu  1 , Hong-Shiue Chou  1 , Wei-Chen Lee  1
Affiliations

Implementation of sorafenib treatment for advanced hepatocellular carcinoma: an illustration of current practice in Taiwan

Kun-Ming Chan et al. Cancer Manag Res. .

Abstract

Background: Sorafenib is the first regimen listed in the treatment algorithm for hepatocellular carcinoma (HCC) worldwide. This study aimed to assess the efficacy of sorafenib treatment for advanced HCC in a clinical practice using a nationwide population study.

Methods: All patients registered with a diagnosis of primary HCC and identified as having been prescribed sorafenib between August 2012 and December 2015 were selected from a national database and retrospectively reviewed. Outcomes related to prescription of sorafenib for these patients were further assessed.

Results: A total of 9,738 patients were enrolled and analyzed. As a result, 32.33% of patients had an initial treatment response and were eligible for the prescribed second term (240 tablets/ term) of sorafenib and 8.91% of patients received more than three terms of sorafenib. Meanwhile, the duration of sorafenib usage beyond 6 months was noted in 15.49% of patients, including 10.59% of patients with a period of usage between 6 and 12 months and 4.9% of patients with more than 12 months usage. Survival analysis showed that patients who received locoregional therapy plus sorafenib had significantly better survival rates than those who underwent only sorafenib treatment. Certain patients who underwent hepatectomy (n=12) or liver transplantation (n=13) were subsequently free of HCC.

Conclusion: The disease control rate of sorafenib in advanced HCC patients in this study seemed similarly poorer as what has been previously reported by clinical trials. The combination of sorafenib and additional treatments could perhaps provide survival benefits and possibly cure disease in combination with surgical management.

Keywords: hepatectomy; hepatocellular carcinoma; liver transplantation; locoregional therapy; outcome; sorafenib.

PubMed Disclaimer

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Kaplan–Meier plots of time to discontinuation of sorafenib for all patients.
Figure 2
Figure 2
Kaplan–Meier plots of overall survival for all patients.
Figure 3
Figure 3
Comparison of Kaplan–Meier cumulative overall survival curves based on additional locoregional therapy. Group 1, patients had received sorafenib and additional locoregional therapy. Group 2, patients had only sorafenib treatment (P<0.0001).
Figure 4
Figure 4
Kaplan–Meier survival curves in patients based on additional locoregional therapy after propensity score matching. The outcomes of patients who had received additional locoregional therapy were also significantly better than those of patients who had only given sorafenib treatment. Group 1, patients had received sorafenib and additional locoregional therapy. Group 2, patients had only sorafenib treatment (P<0.0001).
See this image and copyright information in PMC

References

    1. Stravitz RT, Heuman DM, Chand N, et al. Surveillance for hepatocellular carcinoma in patients with cirrhosis improves outcome. Am J Med. 2008;121(2):119–126. - PubMed
    1. Llovet JM, Bruix J. Systematic review of randomized trials for unresectable hepatocellular carcinoma: chemoembolization improves survival. Hepatology. 2003;37(2):429–442. - PubMed
    1. Lopez PM, Villanueva A, Llovet JM. Systematic review: evidence-based management of hepatocellular carcinoma – an updated analysis of randomized controlled trials. Aliment Pharmacol Ther. 2006;23(11):1535–1547. - PubMed
    1. Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med. 2008;359(4):378–390. - PubMed
    1. Chang YS, Adnane J, Trail PA, et al. Sorafenib (Bay 43-9006) inhibits tumor growth and vascularization and induces tumor apoptosis and hypoxia in RCC xenograft models. Cancer Chemother Pharmacol. 2007;59(5):561–574. - PubMed