Combination of TACE and Sorafenib Improves Outcomes in BCLC Stages B/C of Hepatocellular Carcinoma: A Single Centre Experience.

Abstract

BACKGROUND AND AIM:

Transarterial chemoembolization (TACE) or sorafenib is recommended for hepatocellular carcinoma BCLC stages B and C respectively. We studied the role of combination of TACE and sorafenib in BCLC stages B/C.

MATERIAL AND METHODS:

We undertook an observational study on a cohort of cirrhotics with HCC from August 2010 through October 2014. Patients in BCLC stages B/C who had received TACE and/or sorafenib were included. mRECIST criteria were used to assess tumor response. The primary end point was overall survival.

RESULTS:

Out of 124 patients, 47.6% were in BCLC-B and 52.4% in BCLCC. Baseline characteristics were comparable. The predominant etiology was cryptogenic (37.2% and 38.5%, p = NS). 49.1% in BCLC-B and 56.9% in BCLC-C had received TACE+sorafenib. In BCLC-B, the overall survival improved from 9 months (95% CI 6.3-11.7) using TACE only to 16 months (95% CI 12.9-19.1) using TACE+sorafenib (p < 0.05). In BCLC-C, addition of TACE to sorafenib improved the overall survival from 4 months (95%CI 3-5) to 9 months (95%CI 6.8-11.2) (p < 0.0001). As per mRECIST criteria, patients on TACE+sorafenib had reduced progressive disease (37.8% vs. 83.3%), improved partial response (43.2% vs. 3.3%) and one had complete response compared to those on sorafenib alone (p < 0.0001) in BCLC-C but not in BCLC-B group. Hand foot syndrome was noted in 27.7% patients on sorafenib and post TACE syndrome in 80.2% patients, but both were reversible. No major adverse events were noted.

CONCLUSION:

TACE+sorafenib was more effective than TACE or sorafenib alone in HCC BCLC stages B or C with a significant survival benefit and improved tumour regression especially in BCLC-C patients.

• Authors: Joy Varghese, Chandan Kedarisetty, Jayanthi Venkataraman, Vijaya Srinivasan, Thiruchunapalli Deepashree, Mangerira Uthappa, Kaliamurthy Ilankumaran, Sanjay Govil, Mettu Reddy, Mohamed Rela
• Journal: Annals of hepatology (Ann Hepatol) 2017 March-April Vol. 16 Issue 2 Pg. 247-254 ISSN: 1665-2681 [Print] Mexico
• PMID: 28233748 (Publication Type: Journal Article, Observational Study)

Chemical References

• Antineoplastic Agents
• Phenylurea Compounds
• Protein Kinase Inhibitors
• Niacinamide
• Sorafenib

Topics

• Antineoplastic Agents (adverse effects, therapeutic use)
• Carcinoma, Hepatocellular (etiology, mortality, pathology, therapy)
• Chemoembolization, Therapeutic (adverse effects, mortality)
• Female
• Humans
• India
• Kaplan-Meier Estimate
• Liver Cirrhosis (complications)
• Liver Neoplasms (etiology, mortality, pathology, therapy)
• Male
• Middle Aged
• Neoplasm Staging
• Niacinamide (adverse effects, analogs & derivatives, therapeutic use)
• Phenylurea Compounds (adverse effects, therapeutic use)
• Protein Kinase Inhibitors (adverse effects, therapeutic use)
• Sorafenib
• Time Factors
• Treatment Outcome
• Tumor Burden