Addition of Local Hepatic Therapy to Sorafenib in Patients with Advanced Hepatocellular Carcinoma (Stage BCLC C)

Abstract

Background/Aims: For most patients with hepatocellular carcinoma (HCC), diagnosis is invariably done only in the advanced stages of the disease. For advanced, non-metastatic stage, standard therapy is transarterial chemoembolization (TACE). For metastatic disease, the recommended therapy is systemic treatment with sorafenib. In this study, we evaluated the benefit of an additional local hepatic treatment for patients with advanced metastatic disease. Methods: In a retrospective study, we assessed the overall survival (OS), time to progression (TTP), and disease control rate (DCR) in 37 patients with metastasized HCC treated with sorafenib. Sixteen patients received additional local therapy, while 21 patients received only sorafenib. Results: Median OS of patients with combined therapy was significantly higher with 25 months (95% CI: 13.7-36.3 months) as compared to 11 months (95% CI: 6.2-15.8 months) in patients treated with sorafenib alone. TTP was 7 months (95% CI: 5.3-8.7 months) compared to 5 months (95% CI: 3-7 months) and DCR was 87 versus 72% after 3 months and 31 versus 22% after 9 months. Conclusion: These data suggest that control of the liver tumor burden by local therapy in combination with sorafenib might prove beneficial for metastasized HCC. Randomised studies are needed to confirm this exploratory finding. © 2014 S. Karger AG, Basel

Impact of Hepatitis C Virus Eradication on the Clinical Outcome of Patients with Hepatitis C Virus-Related Advanced Hepatocellular Carcinoma Treated with Sorafenib

“…On the other hand, PPS after sorafenib failure was significantly longer in the SVR group than in the non-SVR group. Previously, the importance of additional therapy after sorafenib failure for prolongation of survival has been reported [17][18][19] . Improvement of the hepatic functional reserve by HCV eradication may prevent the deterioration of liver function after sorafenib failure, enable administration of additional therapies, and improve PPS and OS in patients with an SVR.…”

Treatment of Advanced Hepatocellular Carcinoma after Failure of Sorafenib Treatment: Subsequent or Additional Treatment Interventions Contribute to Prolonged Survival Postprogression

“…Additional local treatment options might be beneficial for controlling the liver tumor burden in patients with metastasized HCC [16]. However, a prospective randomized phase 3 trial conducted in Japan and Korea failed to show a combined effect of TACE and sorafenib [17].…”

Iodine-125 implantation plus transarterial chemoembolization for the treatment of hepatocellular carcinoma of 3–5cm: A propensity score matching study

“…Furthermore, TACE has gained ground in treatment of patients with late-stage HCC after being combined with radiotherapy, resulting in a reduction of mortality rate [22,23] A c c e p t e d M a n u s c r i p t patients with late-stage HCC [32].…”