Changes in plasma vascular endothelial growth factor at 8 weeks after sorafenib administration as predictors of survival for advanced hepatocellular carcinoma.
Bottom Line: 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).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.
Affiliation: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.Show MeSH
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Mentions: In univariate analysis, among all patients, a VEGF decease and an AFP response were associated significantly with OS after starting sorafenib. Major vascular invasion and PD, as evidenced by radiologic findings after sorafenib administration, also were significant prognostic factors. To predict which patients would have a highly favorable prognosis, the prognostic factors associated with 1-year survival after starting sorafenib were assessed in univariate and multivariate analyses. In the univariate analysis, a VEGF decrease, PD, and major vascular invasion were associated significantly with survival (Table 3). In the multivariate analysis, which was performed using those factors as covariates, a VEGF decrease was identified as an independent factor associated significantly with survival (Table 3). There was a significant difference in OS among the 3 groups (patients with a VEGF decrease and non-PD, patients without a VEGF decrease but non-PD, and patients without a VEGF decrease and PD; P = .0013) (Fig. 5). Only 1 patient who had a VEGF decrease was classified with PD. All 4 patients who had a VEGF decrease and an objective response (CR or PR) were able to survive during the observation period.
Affiliation: Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Tokyo, Japan.