Sorafenib for recurrence of hepatocellular carcinoma after liver transplantation

Weinmann, Arndt; Niederle, Ina M.; Koch, Sandra; Hoppe‐Lotichius, Maria; Heise, Michael; Düber, Christoph; Schuchmann, Marcus; Otto, Gerd; Galle, Peter R.; Wörns, Marcus‐Alexander

doi:10.1016/j.dld.2011.12.009

Cited by 60 publications

(50 citation statements)

References 45 publications

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“…Many trials have reported on the use of sorafenib to prevent hepatocellular carcinoma recurrence after treatment 27. Sorafenib is used with sirolimus or with inhibitors of mammalian target of rapamycin29 to reduce the risk of recurrence of hepatocellular carcinoma after liver transplantation,28 and it has been reported that such combination therapy can be effective. Some adjuvant therapy studies after curative treatment for hepatocellular carcinoma, such as the STORM (Sorafenib as adjuvant Treatment in the prevention Of Recurrence of hepatocellular carcinoMa) trial, are ongoing,27 and concurrent treatment of hepatocellular carcinoma with conventional transarterial chemoembolization and sorafenib has demonstrated a longer time to progression and possible efficacy 30,31.…”

Section: Discussionmentioning

confidence: 99%

Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma

Nojiri¹,

Kusakabe²,

Fujiwara³

et al. 2012

CMAR

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BackgroundSorafenib has been approved in the indication of unresectable hepatocellular carcinoma, but there are many cases in which administration of the drug is discontinued due to severe side effects. In this study, we compared the characteristics of patients who continued and discontinued sorafenib.MethodsNinety-six patients (75 men and 21 women) were initiated on sorafenib from July 2009 through September 2011. The patient characteristics of interest included gender, age, etiology, Child-Pugh classification, treatment history and frequency, and levels of α-fetoprotein, des- gamma-carboxy prothrombin, aspartate amino acid transferase, and alanine aminotransferase. Duration of administration of sorafenib and reasons for its discontinuation were compared.ResultsMedian overall survival was 11.8 months. Discontinuation of sorafenib within 90 days was identified as an independent prognostic factor for overall survival on multivariate analysis (P < 0.0001). Transarterial chemoembolization performed six times or more (P = 0.013) was also identified as an independent factor contributing to discontinuation of sorafenib within 90 days in multivariate analysis. Patients who received sorafenib for ≥90 days had significantly longer overall survival than those who discontinued it (P < 0.0001).ConclusionProlonged treatment with sorafenib is an important factor in achieving extended overall survival. We recommend starting sorafenib before latent liver damage has occurred as a result of too many transarterial chemoembolization procedures.

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Section: Discussionmentioning

confidence: 99%

Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma

Nojiri¹,

Kusakabe²,

Fujiwara³

et al. 2012

CMAR

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“…In patients with advanced HCC and compensated liver cirrhosis, sorafenib has been shown to improve survival by approximately 3 months [79]. In addition, several groups have also reported survival benefits of sorafenib treatment in patients with HCC recurrence after LT based on their retrospective experience, in most cases in combination with mTOR inhibitor-based immunosuppression [75][76][80][81]. According to a case-control study by Sposito et al [80], median survival following recurrence in the sorafenib group was significantly longer than that in the nonsorafebib group (21.3 vs 11.8 months, hazard ratio = 5.2, p = 0.0009).…”

Section: Treatment Of Hcc Recurrence After Ltmentioning

confidence: 98%

Liver Transplantation for Advanced Hepatocellular Carcinoma: How Far Can We Go?

Suh

Lee

2015

Hepat. Oncol.

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Liver transplantation is one of the most effective treatment options for hepatocellular carcinoma. Although the Milan criteria have been widely used to identify suitable candidates for liver transplant with a good prognosis, many transplant centers have developed and actually used more expanded criteria. Living donor liver transplant (LDLT) is at the center of expansion of criteria because it is based on the personal relationship between a recipient and a donor. Asian LDLT centers have developed various expanded criteria for LDLT using tumor biologic markers as well as the size and number of the tumors. However, there is no consensus on the limit of the expansion of criteria. Here, we present our experience and opinion on LDLT for advanced hepatocellular carcinoma.

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“…In patients with advanced HCC and compensated liver cirrhosis, sorafenib has been shown to improve survival by~3 months (62). Several groups have also reported survival benefits of sorafenib treatment in patients with HCC recurrence after LT, in most cases in combination with mTOR inhibitor-based immunosuppression (61,(63)(64)(65). In addition, a few cases of complete remission after sorafenib treatment have been reported (66)(67)(68).…”

Section: How Far We Can Go In Ldlt For Hccmentioning

confidence: 99%

Advancements of liver transplantation for hepatocellular carcinoma in Korea

Lee

Suh

2016

Japanese Journal of Clinical Oncology

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The Milan criteria are still considered the gold standard for patient selection criteria for liver transplantation in patients with hepatocellular carcinoma. However, those criteria may be too strict and thus exclude a significant number of patients who could benefit from liver transplantation. Based on this notion, many expanded selection criteria have been suggested. In Asian countries, where there is a serious shortage of deceased donor organs, living donor liver transplantation accounts for the majority of all liver transplant cases. Because living donor liver transplantation is not controlled by the public allocation system, the indications for living donor liver transplantation can be expanded. In Korea, living donor liver transplantation depends entirely on the discretion of the transplant team and the donor. Hence, Korean transplant centers have had a reasonable amount of experience with liver transplantation for advanced hepatocellular carcinoma. Experiences in Korea show that serum alpha-fetoprotein level, des-gamma-carboxy prothrombin level and positron emission tomography are very useful biomarkers in predicting tumor recurrence after transplantation. Tumors that show favorable levels of these biomarkers might not recur after transplantation despite being morphologically advanced. In addition, combination therapy with mammalian target of rapamycin inhibitors and sorafenib may improve survival even after tumor recurrence. Therefore, in Korea, living donor liver transplantation is considered even for cases of far advanced hepatocellular carcinoma if a recipient has no other effective treatment options and a well-informed donor wishes to willingly participate.

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Sorafenib for recurrence of hepatocellular carcinoma after liver transplantation

Cited by 60 publications

References 45 publications

Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma

Clinical factors related to long-term administration of sorafenib in patients with hepatocellular carcinoma

Liver Transplantation for Advanced Hepatocellular Carcinoma: How Far Can We Go?

Advancements of liver transplantation for hepatocellular carcinoma in Korea

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