Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis

Mancuso, Andrea; Mazzola, Alessandra; Cabibbo, Giuseppe; Perricone, Giovanni; Enea, Marco; Galvano, Antonio; Zavaglia, Claudio; Belli, Luca; Cammà, Calogero

doi:10.1016/j.dld.2015.01.001

Cited by 46 publications

(46 citation statements)

References 45 publications

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“…Adverse events may lead to compromised efficacy due to dose reduction or treatment interruptions. There is high interpatient variability in cumulative drug exposure and responses following sorafenib treatment [2, 3, 10, 11]. In this review, we discuss the clinical pharmacology of sorafenib and highlight genetic variations that may contribute to the diverse pharmacological responses to sorafenib.…”

Section: Introductionmentioning

confidence: 99%

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Gong¹,

Giacomini

Giacomini³

et al. 2017

Pharmacogenetics and Genomics

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Section: Introductionmentioning

confidence: 99%

PharmGKB summary

Gong¹,

Giacomini

Giacomini³

et al. 2017

Pharmacogenetics and Genomics

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“…In the meta-analysis by Mancuso and colleagues, sorafenib appears to be roughly safe and effective in the post-LT setting: the pooled assessment of the 1-year survival rate was 63% (ranging from 18% to 90%). However, these findings should be taken cautiously because of the heterogeneity and low quality of the evaluated studies 15 . Other chemotherapy protocols have been employed with some success in term of prolonged survival and in particular of different profile of toxicity 25 , 26 .…”

Section: Discussionmentioning

confidence: 98%

“…All adverse events were grade 1–3 in severity 6 . A recent meta-analysis of 8 retrospective studies suggested a potential positive role of sorafenib in the post-LT setting, but the 1-year survival positively correlated with an increase in several adverse events: the median incidence for grade 3–4 dermatologic, gastrointestinal toxicity and fatigue were 22.5%, 18% and 16.1%, respectively 15 . All these figures were quite higher than those reported in randomized control trials (RCTs) 16 .…”

Section: Introductionmentioning

confidence: 99%

The role of metronomic capecitabine for treatment of recurrent hepatocellular carcinoma after liver transplantation

Ravaioli

Cucchetti

Pinna

et al. 2017

Sci Rep

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The management of recurrent hepatocellular carcinoma untreatable with surgical options is based on systemic therapy with sorafenib. Due to the high rates of adverse events connected to the therapy with sorafenib, metronomic capecitabine seems a promising strategy for these patients. We analyzed the data of 38 patients with hepatocellular carcinoma recurrent after liver transplantation performed at our center. We compared the outcome of 17 patients receiving metronomic capecitabine versus 20 patients experiencing best supportive care and versus the data of the literature about treatment with sorafenib. In the group treated with metronomic capecitabine we observed an increased survival after tumor recurrence at the univariate and multivariate analysis compared to the group of best supportive care (median 22 months vs. 7 months, p < 0.01). Data from the literature on the use of sorafenib showed outcomes like our study group, with similar patient and tumoral features. The episodes of acute rejection and the tumor stage at the recurrence showed a correlation with patient survival at the univariate analysis. The metronomic capecitabine for hepatocellular cancer recurrent after liver transplantation seems effective without important adverse events and comparable results to sorafenib.

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“…In a recent meta-analysis by Mancuso and colleagues, patients who received sorafenib for recurrent HCC after LT had an overall 1-year survival ranging from 18%-90% with a pooled estimate of 1 year survival at 63%. 159 In a recent analysis of the US cohort of the GIDEON registry, the safety and tolerability of sorafenib was studied in patients with HCC recurrence who had undergone LT or resection. 160 Most adverse events occurred in the first 4 weeks of treatment and the incidence of adverse events resulting in discontinuation of drug were similar in both groups.…”

Section: Sorafenib and Other Raf Kinase Inhibitorsmentioning

confidence: 99%

Liver transplantation for hepatocellular carcinoma: Management after the transplant

Verna

Patel

Aggarwal

et al. 2020

American Journal of Transplantation

106

120

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Hepatocellular carcinoma (HCC) is an increasingly common indication for liver transplantation (LT) in the United States and in many parts of the world. In the last decade, significant work has been done to better understand how to risk stratify LT candidates for recurrence of HCC following transplant using a combination of biomarker and imaging findings. However, despite the high frequency of HCC in the LT population, guidance regarding posttransplant management is lacking. In particular, there is no current evidence to support specific post‐LT surveillance strategies, leading to significant heterogeneity in practices. In addition, there are no current recommendations regarding recurrence prevention, including immunosuppression regimen or secondary prevention with adjuvant chemotherapy. Finally, guidance on treatment of disease recurrence is also lacking and there is significant controversy about the use of immunotherapy in transplant recipients due to the risk of rejection. Thus, outcomes for patients with recurrence are poor. This paper therefore provides a comprehensive review of the current literature on post‐LT management of patients with HCC and identifies gaps in our current knowledge that are in urgent need of further investigation.

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Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis

Cited by 46 publications

References 45 publications

PharmGKB summary

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The role of metronomic capecitabine for treatment of recurrent hepatocellular carcinoma after liver transplantation

Liver transplantation for hepatocellular carcinoma: Management after the transplant

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