Gemcitabine plus oxaliplatin in advanced hepatocellular carcinoma: A large multicenter AGEO study
| Autor: | Touraj Mansourbakht, Olivier Rosmorduc, Laetitia Fartoux, Stéphane Cattan, Mohamed Hebbar, Aziz Zaanan, Julien Taieb, Valérie Boige, Olivier Dubreuil, Nicolas Williet, Franck Bonnetain, Tienhan Sandrine Dabakuyo |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Oncology Sorafenib medicine.medical_specialty Carcinoma Hepatocellular Organoplatinum Compounds Kaplan-Meier Estimate GemOx Deoxycytidine Disease-Free Survival Internal medicine Antineoplastic Combined Chemotherapy Protocols medicine Humans Progression-free survival Aged Proportional Hazards Models Retrospective Studies Aged 80 and over Hepatology Performance status business.industry Standard treatment Liver Neoplasms Middle Aged Prognosis medicine.disease Gemcitabine Oxaliplatin Treatment Outcome Hepatocellular carcinoma Feasibility Studies Female business medicine.drug |
| Zdroj: | Journal of Hepatology. 58:81-88 |
| ISSN: | 0168-8278 |
| DOI: | 10.1016/j.jhep.2012.09.006 |
| Popis: | Background & Aims The current standard treatment for advanced hepatocellular carcinoma (HCC) is sorafenib. This drug is effective but generally does not induce tumor shrinkage and other treatment options are still needed. Methods This retrospective multicenter study included all consecutive patients with advanced HCC treated with gemcitabine and oxaliplatin (GEMOX) between 2001 and 2010. Survival curves were drawn with the Kaplan–Meier method and compared with the log-rank test. Univariate and multivariate analyses were used to evaluate prognostic factors. Results Two hundred four consecutive patients were treated with GEMOX (median age, 60years; men, 86%; underlying cirrhosis, 76%). Grade 3–4 toxicity was observed in 44% of the patients (thrombocytopenia 24%, neutropenia 18%, diarrhea 14%, neurotoxicity 12%) leading to treatment discontinuation in 16% of the cases. The overall response and disease control rates were 22% (95% CI, 16–27) and 66% (95% CI, 59–72), respectively. No clinical or biological factors were associated with the treatment response, and 8.5% of the patients were subsequently eligible for curative-intent therapies after downstaging. Median PFS, TTP, and OS were 4.5 (95% CI, 4–6), 8 (95% CI, 6–11), and 11months (95% CI, 9–14), respectively. In multivariate analysis, gender ( p =0.03), underlying cirrhosis ( p =0.01), CLIP score ( p =0.03), and response to GEMOX ( p Conclusions This large study confirms that GEMOX is effective with manageable toxicity in patients with advanced HCC. Tumor responses permitted potentially curative treatment that was not initially feasible in a significant proportion of patients. |
| Databáze: | OpenAIRE |
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