Efficacy of sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization

Ikeda, Masafumi; Mitsunaga, Shuichi; Shimizu, Satoshi; Ohno, Izumi; Takahashi, Hideaki; Okuyama, Hiroomi; Kuwahara, Akiko; Kondo, Shunsuke; Morizane, Chigusa; Ueno, Hideki; Satake, Mitsuo; Okusaka, Takuji

doi:10.1007/s00535-013-0853-7

Cited by 39 publications

(57 citation statements)

References 21 publications

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“…The efficacy of sorafenib in cases refractory to TACE have been reported previously [29,30]. Ogasawara et al found that time to disease progression and OS were prolonged by switching the treatment to sorafenib in patients with intermediate-stage HCC, if TACE refractoriness was confirmed [30].…”

Section: Discussionmentioning

confidence: 99%

“…Another study compared the efficacy of sorafenib and cisplatin in patients with HCC after refractoriness or failure of TACE and it reported that OS and time to progression (TTP) were longer in patients treated with sorafenib than in patients who underwent HAIC [29]. Ogasawara et al compared the efficacy of sorafenib and continuous TACE treatment in patients with HCC, in addition to the refractoriness or failure of the TACE therapy; OS and TTP were longer in patients who were switched from TACE to sorafenib, than in patients who were treated with TACE alone [30].…”

Section: Introductionmentioning

confidence: 99%

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Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma

Arizumi¹,

Ueshima²,

Minami³

et al. 2015

Liver Cancer

183

175

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Background and Aims: Patients with intermediate-stage hepatocellular carcinoma (HCC) refractory to transcatheter arterial chemoembolization (TACE) are considered to be candidates for sorafenib. The aim of this study was to evaluate the superiority of conversion of treatment to sorafenib on overall survival (OS) for cases refractory to TACE. Methods: This was a retrospective cohort study carried out on 497 patients with HCC who were treated with TACE therapy at our hospital between January 2008 and December 2013. Fifty-six patients were diagnosed as refractory to TACE during their clinical course and they were divided into two cohorts, (1) those who switched from TACE to sorafenib and (2) those who continued TACE. The overall survival (OS) after the time of being refractory to TACE was evaluated between the two groups. Results: After refractoriness to TACE therapy was confirmed, 24 patients continued with TACE (TACE-group) and 32 patients underwent treatment conversion to sorafenib (sorafenib-group). The median OS was 24.7 months in the sorafenib-group and 13.6 months in the TACE-group (p=0.002). Conclusions: Conversion to sorafenib significantly improves the OS in patients refractory to TACE therapy with intermediate-stage HCC. Administration of sorafenib is therefore recommended in such circumstances of TACE treatment failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma

Arizumi¹,

Ueshima²,

Minami³

et al. 2015

Liver Cancer

183

175

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“…Ikeda et al [12] reported that the disease control rate, the time to progression, and the overall survival period of patients whose treatment was switched to sorafenib due to their TACE-refractory status (n = 48; median number of past TACE procedures 4, range 1-9) were better than those in patients whose treatment was switched to hepatic arterial chemo-infusion therapy with cisplatin (n = 66; median number of past TACE procedures 4, range 1-17; 60.4%, 3.9 and 16.4 months vs. 28.8%, 2.0 and 8.6 months, respectively; p < 0.01). Ogasawara et al [13] reported that the overall survival period of patients whose treatment was switched to sorafenib due to their TACE-refractory status (n = 20; ≥3 TACE procedures 45%) was better than that of those of who continued on TACE (n = 36; ≥3 TACE procedures 39%; 24.5 vs. 11.5 months; p = 0.003).…”

Section: Discussionmentioning

confidence: 99%

Tumor Markers AFP, AFP-L3, and DCP in Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization

Hiraoka¹,

Ishimaru²,

Kawasaki

et al. 2015

Oncology

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Background/Aim: We examined tumor marker levels to assess in more detail transcatheter arterial chemoembolization (TACE)-refractory hepatocellular carcinoma (HCC). Materials and Methods: We enrolled patients treated from 2000 to 2011 for HCC beyond the Milan criteria who had good hepatic reserve function (Child-Pugh A) and no portal vein thrombosis or metastases (n = 154). The modified criteria for being TACE-refractory according to the Liver Cancer Study Group of Japan (m-LCSGJ), from which the tumor marker item was excluded, and the Assessment for Retreatment with TACE (ART) score were used for determining whether the HCC was TACE refractory. α-Fetoprotein ≥100 ng/ml, fucosylated α-fetoprotein ≥10%, and des-gamma-carboxy prothrombin ≥100 mAU/ml were used to define whether tumor markers were positive. We added up the number of positive tumor markers as a prognostic score to assess in more detail the evaluation of TACE-refractory HCC. Results: In order to divide the patients into a refractory and nonrefractory group, the m-LCSGJ criteria [mean survival time (MST) 27.1 vs. 49.9 months; p < 0.001] were superior to the ART score (MST 22.0 vs. 35.1 months; p = 0.051). In the refractory group according to the m-LCSGJ criteria, the patients with a low score of positive tumor markers (<2) after 2 sessions of TACE (n = 36) showed a better prognosis than the others (n = 72) (MST 37.7 vs. 23.2 months; p = 0.014). Conclusion: Patients being nonrefractory according to the m-LCSGJ criteria had a better response, and using the number of tumor markers (≥2) is an easy method for predicting the response to TACE and for a more detailed evaluation of TACE-refractory HCC.

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“…These findings were further supported by two meta-analyses of randomized controlled trials, published by Zhang et al21 and Fu et al9 Moreover, SOR also showed significantly improved OS and TTP in patients with intermediate or advanced HCC that is refractory to TACE 10,22,23…”

Section: Introductionmentioning

confidence: 60%

“…A previously published case series reported the beneficial effects of SOR for the treatment of TACE-refractory HCC 10. In addition, a retrospective study showed that the DCR for SOR was 60.4%, the median TTP was 3.9 months, and the median OS was 16.4 months in patients who were refractory to TACE 22. Another study of TACE followed by SOR treatment showed similar results: median OS time (861 vs 467 days) was longer with TACE + SOR treatment than with TACE alone,10 which is in agreement with the results from this study.…”

Section: Discussionmentioning

confidence: 96%

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

Yang

et al. 2017

OTT

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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.

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Efficacy of sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization

Abstract: Sorafenib showed favorable treatment results in patients refractory to TACE. When compared with hepatic arterial infusion chemotherapy using cisplatin, sorafenib demonstrated a significantly higher disease control rate, a longer time to progression and increased overall survival.

Cited by 39 publications

References 21 publications

Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma

Effectiveness of Sorafenib in Patients with Transcatheter Arterial Chemoembolization (TACE) Refractory and Intermediate-Stage Hepatocellular Carcinoma

Tumor Markers AFP, AFP-L3, and DCP in Hepatocellular Carcinoma Refractory to Transcatheter Arterial Chemoembolization

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

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