Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology
Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology
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DOI：
10.7314/apjcp.2013.14.12.7367
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发表时间：
2013-01-01
影响因子：
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通讯作者：
Gumus, Mahmut
中科院分区：
文献类型：
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作者：
Berk, Veli;Kaplan, Mehmet Ali;Gumus, Mahmut
背景：不能手术和转移性肝细胞癌（HCC）与预后差和化疗效率低有关。索拉非尼是一种口服多激酶抑制剂，通过RAF/MEK/ERK途径、血管内皮生长因子受体（VEGFR）和血小板衍生生长因子受体β（PDGFR-β）酪氨酸激酶发挥作用。随机研究表明，索拉非尼对癌症患者的预期寿命和生活质量有显着贡献。本研究的目的是评估土耳其索拉非尼治疗的疗效和副作用。材料与方法：对2008年2月至2012年12月在13个中心接受索拉非尼治疗的103例患者（82例男性，21例女性）的数据进行了评价。中位年龄为61岁，中位ECOG体能状态评分为1分（范围：0-2分）。60例患者（58%）患有B型肝炎，15例患者（15%）患有丙型肝炎感染，12例患者（12%）有饮酒史。所有患者的Child评分均符合我国药品使用许可（Child A）。结果：总共有571个周期的索拉非尼治疗，每例患者的中位数为4个。在可评价的病例中，15例（15%）部分缓解，52例（50%）病情稳定，36例（35%）病情进展。中位无进展生存期为18周，中位总生存期为48周。仅6例患者减少剂量，2例患者因3-4级毒性而停药，18例患者（17%）患有手足综合征，7例患者（7%）腹泻，2例患者（2%）呕吐。结论：这项回顾性研究表明，索拉非尼治疗晚期HCC患者的疗效优于文献，而无进展生存期和总生存期结果相当。副作用发生率表明药物耐受性良好。总之，在现有的治疗方案中，索拉非尼是一种有效的和耐受的药物在不可手术或转移性肝癌患者。
Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-beta) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.