Sorafenib with Transarterial Chemoembolization Achieves Improved Survival vs. Sorafenib Alone in Advanced Hepatocellular Carcinoma: A Nationwide Population-Based Cohort Study

Kok, Victor C.; Chen, Yu-Ching; Chen, Yang‐Yuan; Su, Yu‐Chieh; Ku, Ming-Chang; Kuo, Jung-Tsung; Yoshida, Go J.

doi:10.3390/cancers11070985

Cited by 33 publications

(38 citation statements)

References 38 publications

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“…Our result, that the OS of patients with advanced HCC treated with combination therapy was superior to that of those patients treated with sorafenib alone, maps to the conclusions of 4 retrospective studies [19,31,56,57] but is in contrast to a clinical trial by Zhang and colleagues in 2015 [43]. In this study, despite a numerically greater median OS in the combined-therapy group than in the sorafenib-alone group (7.3 months vs. 6.0 months), no difference was observed between the two groups (P = 0.924).…”

Section: Discussionsupporting

confidence: 85%

The combination therapy of transarterial chemoembolisation and sorafenib is the preferred palliative treatment for advanced hepatocellular carcinoma patients: a meta-analysis

Cheng

Guo

et al. 2020

World J Surg Onc

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Background To compare the efficacy of three types of palliative therapy for advanced hepatocellular carcinoma (HCC), including transarterial chemoembolisation (TACE) monotherapy, sorafenib alone and their combination. Methods The databases of PubMed, Embase and Cochrane Library were retrieved. The odds ratio (OR) with its 95% confidence interval (CI) was used to investigate the binary variables, and the standardised mean difference (SMD) with its 95% CI was employed to evaluate the continuous variables. All statistical tests were performed by using Stata/SE, version 12.0. Results Thirty-one clinical studies, containing 5125 unique cases of patients with advanced HCC, were included. There were significant improvements in overall survival (OS) (pooled SMD = 2.54; 95% CI 1.74–3.34) and time to progression (TTP) (pooled SMD = 2.49; 95% CI 0.87–4.12) of the patients after receiving the combination therapy of TACE and sorafenib, compared to TACE monotherapy, and the OS in the combined treatment cohort was also longer than that in the sorafenib-alone cohort (pooled SMD = 2.92; 95% CI 1.72–4.13). The combination therapy group in comparison to the TACE group benefited a significantly increased overall response rate (ORR) (pooled OR = 2.61; 95% CI 1.43–4.77), 1-year (pooled OR = 2.96; 95% CI 1.71–5.14) and 2-year (pooled OR = 1.64; 95% CI 1.18–2.28) survival rates and reduced disease progression rate (DPR) (pooled OR = 0.47; 95% CI 0.33–0.68); in parallel, the ORR in the group was also significantly higher than that in the sorafenib-alone group (pooled OR = 3.62; 95% CI 1.28–10.22), although without a difference in the DPR (pooled OR = 0.28; 95% CI 0.05–1.48). In addition, we discovered that the 1-year (pooled OR = 1.39; 95% CI 0.84–2.29) and 2-year (pooled OR = 1.70; 95% CI 0.69–4.18) survival rates in the TACE monotherapy cohort were not significantly different to those in the sorafenib-alone cohort. Conclusion The combination therapy is more effective than monotherapy in improving the prognostic outcomes of patients with advanced HCC. Therefore, we recommend it as the preferred treatment intervention for those patients.

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Section: Discussionsupporting

confidence: 85%

The combination therapy of transarterial chemoembolisation and sorafenib is the preferred palliative treatment for advanced hepatocellular carcinoma patients: a meta-analysis

Cheng

Guo

et al. 2020

World J Surg Onc

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“…Although the results of sorafenib combined with TACE in the treatment of advanced HCC were not satisfactory, the combination of apatinib with TACE may provide a new method of combination therapy. Several retrospective studies compared sorafenib combined with TACE versus sorafenib alone for advanced HCC and found that combination therapy improved the patients' survival [14,15].…”

Section: Discussionmentioning

confidence: 99%

“…However, a recent phase III clinical trial showed that the addition of TACE to sorafenib failed to achieve significant survival benefit [6]. The reported median OS in sorafenib plus TACE group ranged between 12.8 and 17.3 months [6,[14][15][16]. In contrast, although the combination of apatinib with TACE was compared with TACE alone, the median OS of the combined treatment group was reported to be 11.9-22 months [17][18][19][20][21].…”

Section: Discussionmentioning

confidence: 99%

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Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors

Liu

Kan

Zhang

et al. 2020

Preprint

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Backgroud: To evaluate the overall survival (OS) after transarterial chemoembolization (TACE) combined with apatinib in patients with advanced hepatocellular carcinoma (HCC), and to identify the factors affecting patient survival. Methods: Fifty-one patients with HCC who received TACE combined with apatinib in our hospital from June 2015 to May 2017 were enrolled and followed up until May 2019. The OS and progression-free survival (PFS) were calculated using the Kaplan-Meier method. Log-rank test and Cox regression model were used to determine the factors affecting the patients’ OS. Results: The median OS and PFS of the patients were 15 months and 10 months, respectively. The 1-, 2-, and 3-year survival rates were 62.7%, 23.5%, and 1.8%, respectively. Univariate survival analysis showed that patients with Child-Pugh A (P = 0.008), severe reduction rate of proper hepatic artery (P = 0.013), hand-foot syndrome (P = 0.006), secondary hypertension (P = 0.042), AFP< 400 ug/L (P = 0.076), and without ascites (P = 0.013) had a better OS. Multivariate analysis showed that hand-foot syndrome (P = 0.004), secondary hypertension (P = 0.034), and reduction rate of proper hepatic artery (P = 0.028) were independent predictors of better OS. Conclusions: TACE combined with apatinib is a promising treatment for advanced HCC. Hand-foot syndrome, secondary hypertension, and the reduction rate of proper hepatic artery were associated with a better OS.

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“…Although technology was improved thereby promoting the development of HCC therapy, the treatment outcomes of HCC with PVTT remains poor, as expected. Currently, sorafenib or lenvatinib, transarterial chemoembolization (TACE), TACE plus sorafenib, percutaneous radiofrequency ablation (RFA), and radiotherapy, among others, are used in the clinical treatment of PVTT, but these treatment options remain unsatisfactory (8)(9)(10). Therefore, further research is urgently needed to investigate the optimal therapeutic strategy for HCC with PVTT.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Radiofrequency Ablation Combined With Transarterial Chemoembolization Plus Sorafenib for Large Hepatocellular Carcinoma Invading the Portal Venous System: A Prospective Randomized Study

et al. 2020

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Background: Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) portends a worse prognosis. The objective of this study was to compare the efficacy of percutaneous radiofrequency ablation (RFA) combined with transarterial chemoembolization (TACE) plus sorafenib to that of the most commonly utilized regimen of TACE plus sorafenib in large HCCs with type I/II PVTT. Methods: An open-label, single-center, prospective, randomized trial of participants with tumors ≥5 cm and type I/II PVTT was performed. Participants with previously untreated HCCs were divided into two groups: RFA + cTACE + sorafenib (study group, n = 40) and cTACE + sorafenib (control group, n = 40). The primary endpoint was the objective response rate (ORR), the secondary endpoints included the overall survival (OS); time to progression (TTP); and toxicity. Prognostic factors were analyzed using cox-regression analysis. Results: 80 patients were enrolled into this study with integrated clinical data. Under a median follow-up of 506 days, the median age was 57.5 years (range: 28-80 years). The ORR of study group was higher than control group (70% vs 22.5%, p<0.001). Furthermore, the median OS of study group was superior to that of control group (468 days vs 219 days, HR: 0.44 [95% CI: 0.25-0.78], P = 0.005). Adverse events occurred with 100% probability in both groups (p>0.99), but no treatment-related deaths were recorded. Tumor encapsulation and attaining treatment response predict favorable OS in a multivariate Cox model. The rates of adverse events in both groups were 100% (p>0.99). There were no treatment-related deaths.

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Sorafenib with Transarterial Chemoembolization Achieves Improved Survival vs. Sorafenib Alone in Advanced Hepatocellular Carcinoma: A Nationwide Population-Based Cohort Study

Cited by 33 publications

References 38 publications

The combination therapy of transarterial chemoembolisation and sorafenib is the preferred palliative treatment for advanced hepatocellular carcinoma patients: a meta-analysis

The combination therapy of transarterial chemoembolisation and sorafenib is the preferred palliative treatment for advanced hepatocellular carcinoma patients: a meta-analysis

Transarterial chemoembolization combined with apatinib for treatment of advanced hepatocellular carcinoma: analysis of survival and prognostic factors

Percutaneous Radiofrequency Ablation Combined With Transarterial Chemoembolization Plus Sorafenib for Large Hepatocellular Carcinoma Invading the Portal Venous System: A Prospective Randomized Study

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