Sorafenib therapy following resection prolongs disease-free survival in patients with advanced hepatocellular carcinoma at a high risk of recurrence

Abstract

Abstract. Sorafenib is the standard systemic treatment for patients with advanced hepatocellular carcinoma (HCC); however, its therapeutic value in patients with HCC following resection remains controversial. The current retrospective study was undertaken to assess the effects of sorafenib treatment following surgical resection in patients with advanced HCC disease who were at a high risk for recurrence. Between July 2010 and July 2013, a consecutive cohort of 42 patients with advanced HCC and at a high risk of recurrence (i.e., those with portal vein tumor thrombosis, adjacent organ involvement or tumor rupture) who underwent resection were analyzed. The patients were categorized into the sorafenib group (n=14) or the best supportive care (BSC) group (n=28). Although the histological grade, Barcelona Clinic Liver Cancer Stage, tumor size, nodule number and proportion of patients with high serum α-fetoprotein levels were comparable between the sorafenib and BSC groups, those receiving sorafenib following resection had significantly longer disease-free survival (DFS) of 5.2 months [95% confidence interval (CI), 1.2-9.2 months] compared with the BSC group [1.8 months (95% CI, 0.6-3.0 months)]. No differences in overall survival were noted between the groups. Furthermore, no drug-related adverse events resulted in discontinuation of sorafenib therapy. Univariate log-rank analysis revealed that sorafenib treatment (P=0.002) and treatment prior to resection (P=0.012) were significantly associated with longer DFS; however, sorafenib therapy (P= 0.027) and tumor size (P= 0.028) were associated with longer DFS by multivariate analysis. Furthermore, sorafenib was well-tolerated and improved DFS in patients with advanced HCC who underwent hepatic resection. Thus, tumor resection followed by sorafenib therapy may represent an effective therapeutic strategy for patients with advanced HCC. This possibility should be confirmed in larger, multicenter studies.

Sorafenib for Advanced Hepatocellular Carcinoma: A Real-Life Experience

“…Hepatocellular carcinoma (HCC) is the fifth most prevalent malignant tumor and the third most common cause of cancer mortality worldwide [1,2]. In Brazil, the incidence of HCC ranges from 3.3 to 6.0% per 1,00,000 persons per year, and this rate is similar to mortality rates, due to the high levels of intrahepatic recurrence, distant metastasis, and the lack of effective treatment for the cas- es diagnosed at an advanced stage [2,3].…”

“…In Brazil, the incidence of HCC ranges from 3.3 to 6.0% per 1,00,000 persons per year, and this rate is similar to mortality rates, due to the high levels of intrahepatic recurrence, distant metastasis, and the lack of effective treatment for the cas- es diagnosed at an advanced stage [2,3]. Brazilian data indicate greater HCC prevalence in men aged over 50 years, with cirrhosis and infection by hepatitis C virus (HCV) [3].…”

“…Sorafenib (SOR), a multikinase inhibitor with anti-proliferative and anti-angiogenic activity, was the first systemic therapy approved by the Food and Drug Administration (FDA) for patients with a diagnosis of advanced HCC [2,5,7,10]. SHARP and the Asia Pacific trials have demonstrated that SOR use can increase the overall survival by 3 months when compared to the placebo [11,12].…”

FCN3 Is a Prognostic Biomarker Correlated with Immune Response in Liver Cancer

“…Although a variety of treatments for liver cancer exist, including surgical resection, radiofrequency ablation, sorafenib targeted therapy, chemotherapy, liver transplantation [10][11][12][13][14] and emerging immunotherapy [15,16], due to the high recurrence rate, the 3-year survival rate and 5-year survival rate are still very low [17]. Hence, identifying reliable and effective biomarkers to evaluate the diagnosis, treatment and prognosis of patients with liver cancer is urgently needed.…”

Multiple Antigen Stimulating Cellular Therapy (MASCT) For Hepatocellular Carcinoma After Curative Treatment: A Retrospective Study

“…Indeed, HCC researchers are constantly aiming to find ways to prevent recurrence and improve prognosis in patients who have had curative treatment. In recent years, many studies have focused on postoperative adjuvant treatments, such as transcatheter arterial chemoembolization (TACE) 8 - 10 and sorafenib 11 - 12 . However, the benefit of these therapies for postoperative adjuvant treatment remains unclear.…”