Sorafenib for the Treatment of Advanced Hepatocellular Cancer - a UK Audit.

Autor: King J; Department of Oncology, Royal Free London NHS Foundation Trust, London, UK., Palmer DH; University of Birmingham, Birmingham, UK; University of Liverpool, Liverpool, UK; Clatterbridge Cancer Centre, Wirral, UK., Johnson P; University of Birmingham, Birmingham, UK; University of Liverpool, Liverpool, UK; Clatterbridge Cancer Centre, Wirral, UK., Ross P; King's College Hospital, London, UK., Hubner RA; The Christie NHS Foundation Trust, Manchester, UK., Sumpter K; The Newcastle upon Tyne NHS Foundation Trust, Newcastle upon Tyne, UK., Darby S; Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK., Braconi C; University of Glasgow, Beatson West of Scotland Cancer Centre, Glasgow, UK., Iwuji C; Leicester Royal Infirmary, Leicester, UK., Swinson D; Leeds Teaching Hospitals NHS Trust, Leeds, UK., Collins P; University Hospitals Bristol NHS Foundation Trust, Bristol, UK., Patel K; Oxford University Hospitals NHS Trust, Oxford, UK., Nobes J; Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, UK., Muazzam I; Hull and East Yorkshire Hospitals NHS Trust, Hull, UK., Blesing C; Great Western Hospital NHS Trust, Swindon, UK., Kirkwood A; Cancer Research UK & UCL Cancer Trials Centre, London, UK., Nash S; Cancer Research UK & UCL Cancer Trials Centre, London, UK., Meyer T; Department of Oncology, Royal Free London NHS Foundation Trust, London, UK; UCL Cancer Institute, London, UK. Electronic address: t.meyer@ucl.ac.uk.
Jazyk: angličtina
Zdroj: Clinical oncology (Royal College of Radiologists (Great Britain)) [Clin Oncol (R Coll Radiol)] 2017 Apr; Vol. 29 (4), pp. 256-262. Date of Electronic Publication: 2016 Dec 10.
DOI: 10.1016/j.clon.2016.11.012
Abstrakt: Aims: Sorafenib is the current standard treatment for advanced hepatocellular carcinoma. We carried out a national audit of UK patients treated with sorafenib as standard-of-care and those treated with systemic therapy in first-line trials.
Materials and Methods: Sorafenib-treated and trial-treated patients were identified via the Cancer Drugs Fund and local databases. Data were collected retrospectively from medical records according to a standard case report form. The primary outcome measure was overall survival, estimated by the Kaplan-Meier method.
Results: Data were obtained for 448 sorafenib-treated patients from 15 hospitals. The median age was 68 years (range 17-89) and 75% had performance status ≤ 1. At baseline, 77% were Child-Pugh A and 16.1% Child-Pugh B; 38% were albumin-bilirubin grade 1 (ALBI-1) and 48% ALBI-2; 23% were Barcelona Clinic Liver Classification B (BCLC-B) and 72% BCLC-C. The median time on sorafenib was 3.6 months, with a mean daily dose of 590 mg. The median overall survival for 448 evaluable sorafenib-treated patients was 8.5 months. There were significant differences in overall survival comparing Child-Pugh A versus Child-Pugh B (9.5 versus 4.6 months), ALBI-1 versus ALBI-2 (12.9 versus 5.9 months) and BCLC-B versus BCLC-C (13.0 versus 8.3 months). For trial-treated patients (n=109), the median overall survival was 8.1 months and this was not significantly different from the sorafenib-treated patients.
Conclusion: For Child-Pugh A patients with good performance status, survival outcomes were similar to those reported in global randomised controlled trials. Patients with ALBI grade > 1, Child-Pugh B or poor performance status seem to derive limited benefit from sorafenib treatment.
(Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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