Changes in plasma vascular endothelial growth factor at 8 weeks after sorafenib administration as predictors of survival for advanced hepatocellular carcinoma.
Changes in plasma vascular endothelial growth factor at 8 weeks after sorafenib administration as predictors of survival for advanced hepatocellular carcinoma.
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索拉非尼施用后8周，血浆血管内皮生长因子的变化是晚期肝细胞癌生存的预测指标。
DOI：
10.1002/cncr.28384
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发表时间：
2014-01-15
期刊：
影响因子：
6.2
通讯作者：
Izumi, Namiki
中科院分区：
文献类型：
--
作者：
Tsuchiya, Kaoru;Asahina, Yasuhiro;Matsuda, Shuya;Muraoka, Masaru;Nakata, Toru;Suzuki, Yuichiro;Tamaki, Nobuharu;Yasui, Yutaka;Suzuki, Shoko;Hosokawa, Takanori;Nishimura, Takashi;Ueda, Ken;Kuzuya, Teiji;Nakanishi, Hiroyuki;Itakura, Jun;Takahashi, Yuka;Kurosaki, Masayuki;Enomoto, Nobuyuki;Izumi, Namiki
需要一种新的预测性生物标志物来确定接受索拉非尼治疗的肝细胞癌（HCC）患者的预后，因为索拉非尼实现肿瘤大小减小是罕见的，即使在预后良好的患者中也是如此。血管内皮生长因子（VEGF）受体是索拉非尼的靶点。在目前的研究中，作者检查了索拉非尼治疗期间血浆VEGF浓度的变化，并确定了VEGF作为HCC患者预后指标的临床意义。对63例晚期HCC患者索拉非尼治疗前和治疗期间的血浆VEGF浓度进行了连续测定。在8周时从治疗前水平降低>5%的血浆VEGF浓度被定义为“VEGF降低”。在治疗开始后1个月和此后每3个月，使用改良的实体瘤疗效评价标准确定客观肿瘤缓解。第8周时VEGF降低的患者（n = 14）的中位生存期长于VEGF未降低的患者（n = 49; 30.9个月vs 14.4个月; P = 0.038）。所有VEGF降低的患者均存活>6个月，VEGF降低和甲胎蛋白应答的患者（n = 6）在观察期内存活（中位数，19.7个月;范围，6.5-31.0个月）。在单因素分析中，VEGF降低、影像学表现为疾病进展和大血管浸润与1年生存率显著相关;在多因素分析中，VEGF降低被确定为与生存率显著相关的独立因素。开始索拉非尼治疗后8周血浆VEGF浓度降低可能预示晚期HCC患者的总体生存率良好。
A new predictive biomarker for determining prognosis in patients with hepatocellular carcinoma (HCC) who receive sorafenib is required, because achieving a reduction in tumor size with sorafenib is rare, even in patients who have a favorable prognosis. Vascular endothelial growth factor (VEGF) receptor is a sorafenib target. In the current study, the authors examined changes in plasma VEGF concentrations during sorafenib treatment and determined the clinical significance of VEGF as a prognostic indicator in patients with HCC. Plasma VEGF concentrations were serially measured in 63 patients with advanced HCC before and during sorafenib treatment. A plasma VEGF concentration that decreased >5% from the pretreatment level at 8 weeks was defined as a “VEGF decrease.” An objective tumor response was determined using modified Response Evaluation Criteria in Solid Tumors 1 month after the initiation of therapy and every 3 months thereafter. Patients who had a VEGF decrease at week 8 (n = 14) had a longer median survival than those who did not have a VEGF decrease (n = 49; 30.9 months vs 14.4 months; P = .038). All patients who had a VEGF decrease survived for >6 months, and the patients who had both a VEGF decrease and an α-fetoprotein response (n = 6) survived during the observation period (median, 19.7 months; range, 6.5-31.0 months). In univariate analyses, a VEGF decrease, radiologic findings classified as progressive disease, and major vascular invasion were associated significantly with 1-year survival; and, in multivariate analysis, a VEGF decrease was identified as an independent factor associated significantly with survival. A plasma VEGF concentration decrease at 8 weeks after starting sorafenib treatment may predict favorable overall survival in patients with advanced HCC.
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