Sorafenib for the Treatment of Hepatocellular Carcinoma: A Single-centre Real-world Study
Sorafenib for the Treatment of Hepatocellular Carcinoma: A Single-centre Real-world Study
复制标题
索拉非尼治疗肝细胞癌：一项单中心真实世界研究
作者：
J. Hanžel;Tajda Košir Božič;B. Štabuc;R. Janša
摘要背景索拉非尼是一种口服多激酶抑制剂，用于治疗肝细胞癌。在随机对照试验中，其疗效在肝功能保存良好和功能状态良好的患者中得到证实。在现实世界中，治疗通常提供给这些标准之外的患者。因此，我们对索拉非尼在肝细胞癌患者中的疗效进行了一项单中心真实世界队列研究。患者和方法我们确定了2015年1月至2018年1月期间开始接受索拉非尼治疗的所有肝细胞癌患者。主要终点为索拉非尼治疗后的总生存期（OS）。研究了与生存率相关的临床和人口统计学变量。结果中位OS为13.4个月（95% CI 8.2-18.6）。多变量考克斯回归确定了更差的ECOG体能状态（HR 2.21; 95% CI 1.56-3.16; P < 0.0001），Child-Pugh C级（HR 52.4; 95% CI 3.20-859; P = 0.005）和既往未接受局部治疗（HR 2.30; 95% CI 1.37-3.86; P = 0.002）与死亡率增加相关。结论仔细选择索拉非尼治疗的患者对于优化结果至关重要。
Abstract Background Sorafenib is an oral multi-kinase inhibitor used for the treatment of hepatocellular carcinoma. Its efficacy in randomised controlled trials was demonstrated in patients with well-preserved liver function and good functional status. In the real-world setting, treatment is often offered to patients outside these criteria. We therefore performed a single-centre real-world cohort study on the efficacy of sorafenib in patients with hepatocellular carcinoma. Patients and methods We identified all patients with hepatocellular carcinoma initiating treatment with sorafenib between January 2015 and January 2018. The primary endpoint was overall survival (OS) since starting sorafenib. Clinical and demographic variables associated with survival were studied. Results The median OS was 13.4 months (95% CI 8.2–18.6). Multivariable Cox’s regression identified worse ECOG performance status (HR 2.21; 95% CI 1.56–3.16; P < 0.0001), Child-Pugh class C (HR 52.4; 95% CI 3.20–859; P = 0.005) and absence of prior locoregional treatment (HR 2.30; 95% CI 1.37–3.86; P = 0.002) to be associated with increased mortality. Conclusions Careful selection of patients for treatment with sorafenib is of paramount importance to optimize outcomes.
DOI：
10.1016/s0015-6264(78)80335-6
发表时间：
1986
期刊：
The New Zealand medical journal
影响因子：
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作者：
D. Woodfield
通讯作者：
D. Woodfield