Efficacy and safety of TACE in combination with sorafenib for the treatment of TACE-refractory advanced hepatocellular carcinoma in Chinese patients: a retrospective study

Abstract

BackgroundTransarterial chemoembolization (TACE) and sorafenib (SOR) are well-established treatments for hepatocellular carcinoma (HCC). This study evaluates the efficacy and safety of SOR combined with TACE in the treatment of patients with TACE-refractory, advanced-stage HCC.MethodsThis retrospective study included 61 patients with TACE-refractory advanced HCC. Patients were divided into TACE + SOR (n=30) and TACE (n=31) treatment groups. Patient demographic and clinical characteristics, overall survival (OS), time to progression (TTP), disease control rate (DCR), and adverse events (AEs) were compared between the two groups.ResultsCompared with TACE alone, the 5-year OS and TTP were prolonged in the TACE + SOR group (median OS: 17.9 vs 7.1 months, P<0.001; median TTP: 9.3 vs 3.4 months, P<0.001). Multivariate analysis showed that Child–Pugh class A (hazard ratio [HR], 0.234; 95% confidence interval [CI], 0.092–0.595), Eastern Cooperative Oncology Group performance status 1 (HR, 0.355; 95% CI, 0.153–0.826), alpha-fetoprotein <400 ng/mL (HR, 0.349; 95% CI, 0.177–0.689), and TACE + SOR treatment (HR, 0.151; 95% CI, 0.071–0.322) were independent, positive predictive factors of OS.ConclusionThe OS and TTP in the combined treatment group were significantly improved when compared with the TACE group. However, no significant difference in DCR was found between these two groups. While no AEs occurred in the TACE group, two patients in the TACE + SOR group experienced severe AEs which were effectively mitigated by lowering the dose of SOR. Thus, SOR in combination with TACE is a safe and effective treatment for advanced-stage, prior-TACE-resistant HCC.

The safety and efficacy of TACE combined with apatinib on patients with advanced hepatocellular carcinoma: a retrospective study

“…Indeed, Wu et al showed that TACE together with sorafenib significantly prolonged the 5-year OS in TACE-refractory advanced HCC compared with the TACE group. 17 Joy Varghese et al also reported that the combination of TACE and sorafenib improved the outcomes of HCC patients with BCLC stage B compared to TACE. 18 Although the combination of TACE with sorafenib has demonstrated certain clinical benefits, the adverse effects associated with sorafenib cannot be completely ignored.…”

Role of locoregional therapies in the wake of systemic therapy

“…18,[35][36][37][38][39] In this context, Wu et al retrospectively examined the safety and efficacy of TACE alone vs. TACE combined with sorafenib in 61 patients with TACE-refractory advanced HCC and reported longer OS and TTP in the combination group (median OS 17.9 vs. 7.1 months, p <0.001; median TTP 9.3 vs. 3.4 months, p <0.001). 40 Similarly, in a retrospective comparison of the combination of TACE and sorafenib vs. TACE alone, Yao et al showed that sorafenib may inhibit portal invasion (median time to portal vein invasion was 14.2 months in the combination group vs. 8.77 months in the TACE alone group; p = 0.073) with only grade 1 and 2 AEs. 41 Another retrospective study compared TACE alone (n = 247) to TACE combined with sorafenib (n = 61) in Child-Pugh A or B patients, with ECOG PS of 0-2, and found that median OS in the combination group was significantly longer than that in the monotherapy group (29.0 ± 7.2 vs. 14.9 ± 1.1 mont hs; p = 0.008).…”

Triclosan treatment decreased the antitumor effect of sorafenib on hepatocellular carcinoma cells

“…The exposure of environmental chemicals, for example, environmental poison or environmental endocrine-disrupting chemicals, remains a public health problem. 25 Certain chemicals can disrupt endocrine system and homeostasis. 25 TCS can be absorbed through human skin and oral mucosa and have been found persist in various human tissues and fluids.…”

“… 25 Certain chemicals can disrupt endocrine system and homeostasis. 25 TCS can be absorbed through human skin and oral mucosa and have been found persist in various human tissues and fluids. 26 Previously, TCS was considered as an endocrine disruptor, which promoted the progress of some endocrine-related human cancers, for example, breast cancer, similar to bisphenol A (BPA).…”