Concurrent sorafenib therapy extends the interval to subsequent TACE for patients with unresectable hepatocellular carcinoma

• Published in: Journal of surgical oncology Vol. 113; no. 6; pp. 672 - 677
• Main Authors: Yao, Xuesong, Yan, Dong, Zeng, Huiying, Liu, Dengzhong, Li, Huai
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2016; Wiley Subscription Services, Inc
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - therapy; Chemoembolization, Therapeutic - methods; Combined Modality Therapy; Female; Follow-Up Studies; hepatocellular carcinoma; Humans; Liver cancer; Liver Neoplasms - mortality; Liver Neoplasms - therapy; Male; Middle Aged; Niacinamide - analogs & derivatives; Niacinamide - therapeutic use; Phenylurea Compounds - therapeutic use; progression; Prospective Studies; sorafenib; survival; Survival Analysis; Time Factors; transarterial chemoembolization; Treatment Outcome; progression; sorafenib; transarterial chemoembolization; hepatocellular carcinoma; survival
• ISSN: 0022-4790; 1096-9098
• DOI: 10.1002/jso.24215

Background and Objectives To compare the impact of concurrent TACE + sorafenib versus TACE alone on overall survival (OS) and time to progression (TTP) in patients with unresectable hepatocellular carcinoma (uHCC). A secondary goal was to determine if sorafenib use increases the interval between courses of TACE. Methods This study enrolled 150 patients with uHCC from June 2011 to June 2014, including 50 treated with TACE + sorafenib and 100 treated with TACE alone. Factors associated with OS and TTP were identified by univariate and multivariate Cox‐regression model analyses. Average TACE interval was defined as TTP/TACE frequency. Results The median OS (21.7 vs. 11.5 months) and TTP (10.2 vs. 6.7 months) were longer in the TACE + sorafenib group compared to the TACE group. Patients receiving combination therapy had higher survival rate (P < 0.032) and longer average interval to TACE (P < 0.001), but lower progression rate (P < 0.001). TACE + sorafenib therapy was associated with improved OS (P ≤ 0.009) and TTP (P ≤ 0.021). The majority of AEs identified in patients receiving the combination therapy were classified as Grades 1 and 2, and skin‐related reactions and fatigue were the most common. Conclusion Concurrent sorafenib with TACE provides survival benefits over TACE monotherapy, which may be related to a prolonged interval between subsequent TACE courses. J. Surg. Oncol. 2016;113:672–677. © 2016 Wiley Periodicals, Inc.