Sorafenib with concurrent multiple-line therapies improves overall survival in advanced stage hepatocellular carcinoma

Pojen Hsiao, Kun-Chou Hsieh, Yaw-Sen Chen, Chia-Chang Hsu, Gin-Ho Lo, Yu-Chan Li, Pei-Min Hsieh, Hung-Yu Lin, Tsung-Chin Wu, Jen-Hao Yeh, Chih-Wen Lin, Pojen Hsiao, Kun-Chou Hsieh, Yaw-Sen Chen, Chia-Chang Hsu, Gin-Ho Lo, Yu-Chan Li, Pei-Min Hsieh, Hung-Yu Lin, Tsung-Chin Wu, Jen-Hao Yeh, Chih-Wen Lin

Abstract

The efficacy of sorafenib in combination with transarterial chemoembolization (TACE) or multiple-line therapies in patients with advanced hepatocellular carcinoma (HCC) remains unclear. This study aimed to investigate the overall survival (OS) of patients with advanced HCC in response to different combination therapies.We analyzed the treatment and OS of 401 patients with Barcelona clinic liver cancer stage C HCC between 2012 and 2017. Mortality was analyzed using multivariate Cox regression, and OS was analyzed by the Kaplan-Meier method.The mean age was 59 years and males were predominant. During a median follow-up time of 8.6 months (range, 1-80 months), 346 (86.2%) patients died. In the multivariate Cox regression analysis, primary tumor size ≥5 cm, serum alpha-fetoprotein ≥200, and serum albumin ≥3.5 were significantly associated with mortality. In addition, compared with sorafenib alone, multiple-line treatments with sorafenib and multiple-line treatments without sorafenib yielded significantly decreased mortality. In the Kaplan-Meier analysis, sorafenib with TACE, multiple-line treatments with sorafenib, third-line treatments with sorafenib, and multiple-line treatments without sorafenib yielded a significantly better median OS than sorafenib alone.Sorafenib with concurrent multiple-line therapies significantly improved OS. These combination therapies will provide important information for immunotherapy combination with locoregional therapies in advanced HCC.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
OS of patients with BCLC C stage HCC who underwent different sorafenib-based therapies, as assessed by Kaplan–Meier analysis. Treatment with sorafenib yielded a significantly better median OS than BSC (P < .001) (A). Sorafenib with concurrent TACE had a significantly better median OS than sorafenib alone (P = .048) (B). Sorafenib with multiple-line treatments resulted in a significantly better median OS than sorafenib alone (P < .015) (C). Sorafenib with third-line treatments yielded a significantly better median OS than sorafenib alone (P < .009) (D). BCLC = Barcelona clinic liver cancer, BSC = best supportive care, HCC = hepatocellular carcinoma, OS = overall survival, TACE = transarterial chemoembolization.
Figure 2
Figure 2
OS of patients with BCLC C stage HCC who underwent multiple-line therapies, as assessed by Kaplan–Meier analysis. Multiple-line treatments yielded a significantly better median OS than first-line treatment (P < .001) (A). Third-line treatments resulted in a significantly better median OS than first-line treatment (P = .015) (B). Treatments with or without sorafenib had a similar median OS (P < .001) (C). Multiple-line treatments with or without sorafenib yielded a significantly better median overall survival than sorafenib alone (P = .013) (D). BCLC = Barcelona clinic liver cancer, HCC = hepatocellular carcinoma, OS = overall survival.

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Source: PubMed

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