Prognostic factors of sorafenib therapy in hepatocellular carcinoma patients with failure of transarterial chemoembolization

Lee, Sangheon; Kang, Jung Hyun; Kim, Do Young; Ahn, Sang Hoon; Park, Jun Yong; Kim, Seung Up; Han, Kwang Hyub

doi:10.1007/s12072-017-9792-3

Cited by 9 publications

(8 citation statements)

References 23 publications

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“…The OS in our study was 4.1 to 6.4 months, whereas other practice-based studies have reported survival of 7.4 to 25.4 months in patients, given sorafenib as rescue therapy after TACE refractoriness. 7,16,17,26,27 Discrepancy may reflect differences in the distribution of patients between our study and the previous studies. In the present study, we included patients with CPC B (34.0%) and BCLC stage C (76.6%) HCC, whereas previous studies had excluded patients with CPC B of BCLC stage C HCC.…”

Section: Discussioncontrasting

confidence: 79%

Transarterial Infusion of Epirubicin and Cisplatin Combined With Systemic Infusion of 5-Flurouracil Versus Sorafenib for Hepatocellular Carcinoma With Refractoriness of Transarterial Chemoembolization Using Doxorubicin

et al. 2020

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Transarterial chemoembolization using doxorubicin (TACE-DOX) is an effective therapy for advanced hepatocellular carcinoma (HCC). However, there are limited options for patients with TACE refractoriness. We compared the effectiveness between sorafenib and transarterial chemolipiodolization using epirubicin and cisplatin combined with systemic infusion of 5-fluorouracil (5-FU; TACL-ECF) in patients with previous TACE-DOX refractoriness. We retrospectively analyzed 742 consecutively enrolled cohort patients who received TACE-DOX as the first-line therapy for HCC. Among the 94 patients who failed with TACE-DOX, 49 patients were treated with TACL-ECF and 45 patients were treated with sorafenib as a rescue therapy. The TACL-ECF regimen comprised transarterial infusion of epirubicin and cisplatin combined with systemic infusion of 5-FU. Of the 94 patients, 22 and 72 patients were in Barcelona Clinic Liver Cancer stages B and C, respectively; 66% patients were classified as having Child-Pugh class A (CPC A). Overall survival (OS) after rescue therapy did not differ between the sorafenib and TACL-ECF groups (4.1 months vs 6.4 months, P = .355). Progression-free survival (PFS) did not differ between the sorafenib and TACL-ECF groups (2.8 months vs 3.5 months, P = .629). Adverse events of CTC grade 3/4 occurred more frequently in the sorafenib group than in the TACL-ECF group ( P = .024). The present study showed that the OS and PFS did not differ between patients given rescue TACL-ECF therapy and those given sorafenib therapy. The TACL-ECF treatment was better tolerated than sorafenib. The TACL-ECF might be considered as an alternative therapy for the patients with TACE-DOX refractoriness, especially CPC B and sorafenib-intolerant patients.

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Section: Discussioncontrasting

confidence: 79%

Transarterial Infusion of Epirubicin and Cisplatin Combined With Systemic Infusion of 5-Flurouracil Versus Sorafenib for Hepatocellular Carcinoma With Refractoriness of Transarterial Chemoembolization Using Doxorubicin

et al. 2020

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“…Macroscopic vascular invasion: It is widely acknowledged that the presence of macroscopic vascular invasion leads to a poorer prognosis[ 26 , 30 ]. The meta-analysis by Peng et al[ 31 ] confirmed its prognostic value and the pooled analysis by Bruix et al[ 6 ] affirmed the importance of macroscopic vascular invasion as a predictor of survival but not of response to treatment.…”

Section: Clinical Parametersmentioning

confidence: 99%

Ten years of sorafenib in hepatocellular carcinoma: Are there any predictive and/or prognostic markers?

Marisi

Cucchetti

Ulivi

et al. 2018

WJG

165

117

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Sorafenib has been considered the standard of care for patients with advanced unresectable hepatocellular carcinoma (HCC) since 2007 and numerous studies have investigated the role of markers involved in the angiogenesis process at both the expression and genetic level and clinical aspect. What results have ten years of research produced? Several clinical and biological markers are associated with prognosis. The most interesting clinical parameters are adverse events, Barcelona Clinic Liver Cancer stage, and macroscopic vascular invasion, while several single nucleotide polymorphisms and plasma angiopoietin-2 levels represent the most promising biological biomarkers. A recent pooled analysis of two phase III randomized trials showed that the neutrophil-to-lymphocyte ratio, etiology and extra-hepatic spread are predictive factors of response to sorafenib, but did not identify any predictive biological markers. After 10 years of research into sorafenib there are still no validated prognostic or predictive factors of response to the drug in HCC. The aim of the present review was to summarize 10 years of research into sorafenib, looking in particular at the potential of associated clinical and biological markers to predict its efficacy in patients with advanced HCC.

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“…Our study demonstrated that the OS of the TACE-refractory group was shorter than that of the TACE-non-refractory group in both the study cohort (540 vs. 1,257 days, p 0.019) and validation cohort (568 vs. 1,324 days). These data indicated that TACE refractoriness, which was associated with the number of tumors and bilobular invasion, could contribute to poor prognosis and impair patients' OS (Johnson et al, 2016;Lee et al, 2017).…”

Section: Discussionmentioning

confidence: 89%

“…In this study, the JSH 2014 definition of TACE refractoriness was chosen because it has been widely accepted by radiologists for relatively easy application. As the earliest definition released, many researchers referred to this version for TACE refractoriness, and examples include Hiraoka A. et al (Hiraoka et al, 2015) and Lee S. et al (Lee et al, 2017 CT and serum AFP results after patients received two consecutive, adequate TACE procedures.…”

Section: Discussionmentioning

confidence: 99%

Development of TACE Refractoriness Scores in Hepatocellular Carcinoma

Chen

Zhong

et al. 2021

Front. Mol. Biosci.

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Purpose: To identify the independent risk factors for transarterial embolization (TACE) refractoriness and to develop a novel TACE refractoriness score and nomogram for predicting TACE refractoriness in patients with hepatocellular carcinoma (HCC).Methods: Between March 2006 and March 2016, HCC patients who underwent TACE monotherapy as initial treatment at two hospitals formed the study cohort and validation cohort. The criteria of TACE refractoriness followed the Japan Society of Hepatology 2014 version of TACE refractoriness. In the study cohort, the independent risk factors for TACE refractoriness were identified, and TACE refractoriness score and nomogram were then developed. The accuracy of the systems was validated externally in the validation cohort.Results: In total, 113 patients from hospital A formed the study cohort and 122 patients from hospital B formed the validation cohort. In the study cohort, 82.3% of the patients (n = 93) developed TACE refractoriness with a median overall survival (OS) of 540 days (95% CI, 400.8–679.1), and the remaining 20 patients in the TACE-non-refractory group had a median OS of 1,257 days (95% CI, 338.8–2,175.2) (p = 0.019). The median time for developing TACE refractoriness was 207 days (95% CI, 134.8–279.2), and a median number of two TACE procedures were performed after refractoriness developed. The independent risk factors for TACE refractoriness were the number of tumors and bilobular invasion of HCC. TACE refractoriness scores <3.5 indicated a lower incidence of TACE refractoriness, whereas scores >3.5 points indicated a higher incidence (p < 0.001). In the validation cohort, 77.9% of the patients (n = 95) developed TACE refractoriness with a median OS of 568 days (95% CI, 416.3–719.7), and a median OS of 1,324 days was observed in the TACE-non-refractory group (n = 27; 95% CI, 183.5–2,464.5).Conclusions: TACE refractoriness impairs the OS of HCC patients. The number of tumors and bilobular invasion status were independent risk factors for TACE refractoriness. The TACE refractoriness score can be an effective tool and easy approach to predict the risk of TACE refractoriness status.

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Prognostic factors of sorafenib therapy in hepatocellular carcinoma patients with failure of transarterial chemoembolization

Abstract: Sorafenib is a potential rescue therapy in patients with TACE failure. However, the clinical benefits need to be further evaluated for patients with main (or lobar) PVI or those treated with reduced doses of sorafenib.

Cited by 9 publications

References 23 publications

Transarterial Infusion of Epirubicin and Cisplatin Combined With Systemic Infusion of 5-Flurouracil Versus Sorafenib for Hepatocellular Carcinoma With Refractoriness of Transarterial Chemoembolization Using Doxorubicin

Transarterial Infusion of Epirubicin and Cisplatin Combined With Systemic Infusion of 5-Flurouracil Versus Sorafenib for Hepatocellular Carcinoma With Refractoriness of Transarterial Chemoembolization Using Doxorubicin

Ten years of sorafenib in hepatocellular carcinoma: Are there any predictive and/or prognostic markers?

Development of TACE Refractoriness Scores in Hepatocellular Carcinoma

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