Practical effect of sorafenib monotherapy on advanced hepatocellular carcinoma and portal vein tumor thrombosis

• Published in: Gut and liver Vol. 7; no. 6; pp. 696 - 703
• Main Authors: Jeong, Soung Won, Jang, Jae Young, Shim, Kwang Yeun, Lee, Sae Hwan, Kim, Sang Gyune, Cha, Sang-Woo, Kim, Young Seok, Cho, Young Deok, Kim, Hong Soo, Kim, Boo Sung, Kim, Kyoung Ha, Kim, Jung Hoon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer 01.11.2013; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: Adult; Aged; Aged, 80 and over; Anorexia - chemically induced; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; carcinoma; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Diarrhea - chemically induced; Disease-Free Survival; Fatigue - chemically induced; Female; Hand-Foot Syndrome - etiology; hepatocellular; Humans; Kaplan-Meier Estimate; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Magnetic Resonance Imaging; Male; Middle Aged; Nausea - chemically induced; Neoplasm Invasiveness; Niacinamide - adverse effects; Niacinamide - analogs & derivatives; Niacinamide - therapeutic use; Original; Phenylurea Compounds - adverse effects; Phenylurea Compounds - therapeutic use; portal vein; Portal Vein - pathology; Proportional Hazards Models; sorafenib; thrombosis; Tomography, Spiral Computed; Venous Thrombosis - drug therapy; Venous Thrombosis - pathology; 내과학; Carcinoma, hepatocellular; Portal vein; Thrombosis; Sorafenib
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl.2013.7.6.696

We investigated the effects of sorafenib monotherapy on advanced hepatocellular carcinoma (HCC) and portal vein tumor thrombosis (PVTT) in a clinical setting. In total, 143 consecutive patients with unresectable HCC were treated with sorafenib. Among these patients, 30 patients with advanced HCC and PVTT (Vp3 or 4) were treated with sorafenib monotherapy. All patients had a performance status of 1 to 2 (Eastern Cooperative Oncology Group 1/2, 20/10) and Child-Pugh class A or B (A/B, 17/13). Eleven patients had modified Union for International Cancer Control stage IVA tumors, whereas 19 had stage IVB tumors. All patients had PVTT (Vp3, 6; Vp4, 24). Following sorafenib monotherapy, three patients (10.0%) had a partial response with PVTT revascularization, and nine (30.0%) had stable disease, with a disease control rate of 33.3%. The median overall survival was 3.1 months (95% confidence interval [CI], 2.70 to 3.50), and the median progression-free survival was 2.0 months (95% CI, 1.96 to 2.05). Fatigue and hand-foot skin reactions were the most troublesome side effects. A limited proportion of patients with advanced HCC and PVTT exhibited a remarkable outcome after sorafenib monotherapy, although the treatment results in this type of patient is extremely poor. Further studies to predict good responders to personalized therapy are warranted.