Sorafenib for the Treatment of Advanced Hepatocellular Cancer - a UK Audit.



King, J, Palmer, DH ORCID: 0000-0002-7147-5703, Johnson, P ORCID: 0000-0003-1404-0209, Ross, P, Hubner, RA, Sumpter, K, Darby, S, Braconi, C, Iwuji, C, Swinson, D
et al (show 8 more authors) (2017) Sorafenib for the Treatment of Advanced Hepatocellular Cancer - a UK Audit. Clinical oncology (Royal College of Radiologists (Great Britain)), 29 (4). 256 - 262.

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Abstract

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.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.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.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: Article
Uncontrolled Keywords: ALBI, Child-Pugh, hepatocellular carcinoma, prognosis, sorafenib
Depositing User: Symplectic Admin
Date Deposited: 17 Jan 2017 08:51
Last Modified: 16 Sep 2022 07:14
DOI: 10.1016/j.clon.2016.11.012
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3005162