Sorafenib for the treatment of advanced hepatocellular cancer – a UK audit

King, J. et al. (2017) Sorafenib for the treatment of advanced hepatocellular cancer – a UK audit. Clinical Oncology, 29(4), pp. 256-262. (doi: 10.1016/j.clon.2016.11.012) (PMID:27964898)

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Aims: Sorafenib is the current standard treatment for advanced hepatocellular carcinoma. We carried out a national audit of UK patients treated with sorafenib as standard-of-care and those treated with systemic therapy in first-line trials. Materials and methods: Sorafenib-treated and trial-treated patients were identified via the Cancer Drugs Fund and local databases. Data were collected retrospectively from medical records according to a standard case report form. The primary outcome measure was overall survival, estimated by the Kaplan–Meier method. Results: Data were obtained for 448 sorafenib-treated patients from 15 hospitals. The median age was 68 years (range 17–89) and 75% had performance status ≤ 1. At baseline, 77% were Child-Pugh A and 16.1% Child-Pugh B; 38% were albumin–bilirubin grade 1 (ALBI-1) and 48% ALBI-2; 23% were Barcelona Clinic Liver Classification B (BCLC-B) and 72% BCLC-C. The median time on sorafenib was 3.6 months, with a mean daily dose of 590 mg. The median overall survival for 448 evaluable sorafenib-treated patients was 8.5 months. There were significant differences in overall survival comparing Child-Pugh A versus Child-Pugh B (9.5 versus 4.6 months), ALBI-1 versus ALBI-2 (12.9 versus 5.9 months) and BCLC-B versus BCLC-C (13.0 versus 8.3 months). For trial-treated patients (n = 109), the median overall survival was 8.1 months and this was not significantly different from the sorafenib-treated patients. Conclusion: For Child-Pugh A patients with good performance status, survival outcomes were similar to those reported in global randomised controlled trials. Patients with ALBI grade > 1, Child-Pugh B or poor performance status seem to derive limited benefit from sorafenib treatment.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Braconi, Dr Chiara
Authors: King, J., Palmer, D.H., Johnson, P., Ross, P., Hubner, R.A., Sumpter, K., Darby, S., Braconi, C., Iwuji, C., Swinson, D., Collins, P., Patel, K., Nobes, J., Muazzam, I., Blesing, C., Kirkwood, A., Nash, S., and Meyer, T.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:Clinical Oncology
ISSN (Online):1433-2981
Published Online:10 December 2016
Copyright Holders:Copyright © 2016 Royal College of Radiologists
First Published:First published in Clinical Oncology 29(4): 256-262
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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