Sorafenib for Advanced Hepatocellular Carcinoma: A Real-Life Experience

Abstract

Introduction: Sorafenib (SOR) has proved to be effective in patients with advanced hepatocellular carcinoma (HCC), since overall survival was higher in phase III clinical trials; however, disease progression can occur. Objectives: The study aimed to describe real-life experience in advanced HCC treatment with SOR at a university hospital in Brazil and to estimate the number of patients with indication of second-line therapy. Methods: This is a retrospective study that included cases of HCC with prescription of SOR based on real-life practice between 2011 and 2016. Demographic, clinical, and laboratory data were collected. Results: From 572 patients with HCC, SOR was prescribed in 103 cases. From them, 62.1% were classified as Child-Pugh (CP)-A, 54.4% as Barcelona Clinic Liver Cancer (BCLC)-C, and 74 (71.8%) started treatment. Overall survival was 25.5 (95% CI 17.0–34.1) months and 1-year survival was greater in patients who received SOR than in non-treated (88.7 vs. 44.4%, p < 0.001). There was no difference in survival between BCLC-B and C (p = 0.405), as well as CP-A and B (p = 0.919). In 21.6% of the patients, a second-line therapy with regorafenib was indicated. Conclusion: In this real-life study, SOR significantly increased the survival rate by 1 year in patients with advanced HCC regardless of BCLC staging and CP score. Second-line therapy would be indicated in 21.6% of cases.

Stearoyl-CoA Desaturase 1 as a Therapeutic Target for the Treatment of Cancer

“…The same inhibitor suppressed the growth of glioma stem-like xenograft in mice, and significantly prolonged survival in the experimental group [90]. Furthermore, SCD1 has been shown to regulate the properties of hepatocellular carcinoma stem cells, determining their metastatic potential and resistance to sorafenib (i.e., a multikinase inhibitor that is approved for the treatment of patients with advanced HCC) [73,157]. The inhibition of SCD1 with A939572 impaired HCC stem cell self-renewal, invasiveness, and sorafenib resistance.…”

Roles and Regulation of Long Noncoding RNAs in Hepatocellular Carcinoma

“…3). For systemic treatment, there are chemotherapy and targeted therapy options, although only sorafenib (6)(7)(8)(9) and regorafenib (10,11), both multityrosine kinase inhibitors, are clinically approved for treating locally advanced or metastatic HCC, which extend survival by only a few months (3). Given the dismal landscape of therapeutic options if diagnosis is made late, there is, therefore, an urgent need for a fine-grained molecular landscape of HCC from which to discover clinically relevant early diagnostic and prognostic biomarkers, and to develop curative precision therapies.…”

Cirrhotic patients and older people

“…Although most cases occur in developing countries, their incidence in developed countries has increased in recent years due to the high prevalence of chronic hepatitis C, immigration from areas where hepatitis B and hepatitis C are common, and the increased prevalence of non-alcoholic fatty liver disease (NAFLD)[2-4]. Heterogeneous data on HCC incidence have been reported in Latin America[2,5-7]. In Brazil, the HCC incidence varies from 3.3%-6.0% per 100000 per year, and the mortality rates are similar due to high intrahepatic recurrence, distant metastasis and lack of effective treatment for cases diagnosed at an advanced stage[8,9].…”