Phase II study of concurrent transarterial chemoembolization and sorafenib in patients with unresectable hepatocellular carcinoma

Park, Joong-Won; Lee, Kyung-Hun; Kim, Hyun Beom; Kim, Hwi Young; An, Sangbu; Choi, Woo Hee; Woo, Sang Myung; Nam, Byung Ho

doi:10.1016/j.jhep.2012.01.006

Cited by 145 publications

(119 citation statements)

References 32 publications

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“…improved survival benefit in patients with stage B disease receiving a combination of sorafenib and transcatheter arterial chemoembolization (TACE) (Chung et al, 2013;Park et al, 2012).…”

Section: Sorafenib Continuation After First Disease Progression Couldmentioning

confidence: 99%

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

Zhang²,

Li³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…improved survival benefit in patients with stage B disease receiving a combination of sorafenib and transcatheter arterial chemoembolization (TACE) (Chung et al, 2013;Park et al, 2012).…”

Section: Sorafenib Continuation After First Disease Progression Couldmentioning

confidence: 99%

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

Zhang²,

Li³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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“…However, some reports suggested that TACE is a safe treatment for patients with advanced HCC and MPVTT if the patient has good liver function and collateral circulation around the MPV [8,10]. Moreover, there has been increased focus on combining TACE with sorafenib to potentially improve the efficacy for patients with unresectable/advanced HCC [11][12][13][14][15]. Therefore, patients with advanced HCC and MPVTT treated with the combination therapy of sorafenib and TACE are expected to show improved survival time.…”

Section: Introductionmentioning

confidence: 99%

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

et al. 2015

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Background. The survival benefit of combining sorafenib and transarterial chemoembolization (TACE) therapy compared with sorafenib monotherapy for patients with advanced hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT) is unclear. Methods. Between January 2009 and June 2013, 183 consecutive patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) and MPVTT were retrospectively reviewed. Of these, 89 patients with advanced HCC and MPVTT were enrolled in this study: 45 were treated with combination therapy (sorafenib‐TACE group), and the other 44 treated with sorafenib monotherapy (sorafenib group). Results. The mean number of TACE sessions per patient was 2.6 (range: 1–5). The median duration of sorafenib in the sorafenib‐TACE group and sorafenib group was 5.6 months and 5.4 months, respectively. The disease control rate was similar between the two groups. Median time to progression was 3.0 months (95% confidence interval [CI]: 2.2, 3.7) in the sorafenib‐TACE group, and 3.0 months (95% CI: 2.1, 3.8) in the sorafenib group (p = .924). Median overall survival was 7.0 months (95% CI: 6.1, 7.8) and 6.0 months (95% CI: 4.7, 7.3) in the sorafenib‐TACE group and the sorafenib group, respectively (p = .544). The adverse events related to sorafenib were comparable between the two groups. Twenty‐one adverse events of grade 3–4 related to TACE occurred in 12 patients (26.7%), and 2 of them died (4.4%). Conclusion. This study demonstrated no advantage of combination therapy over sorafenib monotherapy. Considering the patients’ morbidity after TACE, sorafenib monotherapy is appropriate for managing patients with advanced HCC and MPVTT. Implications for Practice: For patients with advanced hepatocellular carcinoma (HCC) and main portal vein tumor thrombosis (MPVTT), no benefit was seen in this study in terms of disease control rate, time to progression, and overall survival for patients receiving sorafenib and transarterial chemoembolization compared with those receiving sorafenib monotherapy. Considering the patients’ morbidity after combination therapy, monotherapy is appropriate for managing patients with advanced HCC and MPVTT.

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“…Another study by Pinter et al [25] showed no difference in survival in patients with advanced stage HCC treated with TACE alone vs sorafenib alone (P = 0.377). However, several other studies showed improved progression-free median survival and disease control rate in patients with advanced HCC who were treated with TACE and sorafenib [26][27][28][29] . Nevertheless, very few studies have compared overall survival (OS) and progression-free survival (PFS) in patients treated with TACE vs combination therapy with sorafenib.…”

Section: Introductionmentioning

confidence: 99%

Comparative effectiveness of traditional chemoembolization with or without sorafenib for hepatocellular carcinoma

Muhammad¹

2013

WJH

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AIM:To compare the overall survival (OS) and progression-free survival (PFS) with associated adverse events (AE) in patients with unresectable hepatocellular carcinoma (HCC) treated with transarterial chemoembolization (TACE) + sorafenib vs TACE alone. METHODS:In this retrospective cohort study we collected data on all consecutive patients with a diagnosis of unresectable HCC between 2007 and 2011 who had been treated with TACE + sorafenib or TACE alone. We hypothesized that the combination therapy is superior to TACE alone in improving the survival in these patients. Data extracted included patient's demographics, etiology of liver disease, histology of HCC, stage of liver disease with respect to model of end stage liver disease score and Child-Turcotte-Pugh (CTP) classification and Barcelona Clinic Liver Cancer (BCLC) staging for HCC. Computed tomography scan findings, alpha fetoprotein levels, number of treatments and related AE were also recorded and analyzed. RESULTS:Of the 43 patients who met inclusion criteria, 13 were treated with TACE + sorafenib and 30 with TACE alone. There was no significant difference in median survival: 20.6 mo (95%CI: 13.4-38.4) for the TACE + sorafenib and 18.3 mo (95%CI: 11.8-32.9) for the TACE alone (P = 0.72). There were also no statistically significant differences between groups in OS (HR = 0.82, 95%CI: 0.38-1.77; P = 0.61), PFS (HR = 0.93, 95%CI: 0.45-1.89; P = 0.83), and treatmentrelated toxicities (P = 0.554). CTP classification and BCLC staging for HCC were statistically significant (P = 0.001, P = 0.04 respectively) in predicting the survival in patients with HCC. The common AE observed were abdominal pain, nausea, vomiting and mild elevation of liver enzymes. CONCLUSION:Combination therapy with TACE + sorafenib is safe and equally effective as TACE alone in patients with unresectable HCC. CTP classification and BCLC staging were the significant predictors of survival. Future trials with large number of patients are needed to further validate this observation.

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Phase II study of concurrent transarterial chemoembolization and sorafenib in patients with unresectable hepatocellular carcinoma

Cited by 145 publications

References 32 publications

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

Sorafenib With and Without Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma With Main Portal Vein Tumor Thrombosis: A Retrospective Analysis

Comparative effectiveness of traditional chemoembolization with or without sorafenib for hepatocellular carcinoma

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