Limits...
Early Clinical Response after 2 Weeks of Sorafenib Therapy Predicts Outcomes and Anti-Tumor Response in Patients with Advanced Hepatocellular Carcinoma.

Kuzuya T, Ishigami M, Ishizu Y, Honda T, Hayashi K, Katano Y, Hirooka Y, Ishikawa T, Nakano I, Goto H - PLoS ONE (2015)

Bottom Line: After 2 weeks of sorafenib therapy, there were 26 patients (45.6%) without disappearance of arterial tumor enhancement on CE-CT, 15 patients (26.3%) with an AFP ratio of >1.2, and seven patients (12.3%) with two or more increments in the CP score.Multivariate analysis showed that the absence of disappearance of arterial tumor enhancement on CE-CT, AFP ratio of >1.2, and two or more increments in the CP score after 2 weeks of sorafenib therapy were significant and independent predictors of worse survival.Upon scoring these three variables as "poor prognostic factors", patients with poor prognostic score 4, 3 or 2 (n = 17) had significantly worse outcomes and a significantly higher progressive disease (PD) rate based on modified Response Evaluation Criteria in Solid Tumors at 6 weeks after sorafenib therapy than those with poor prognostic score 1 or 0 (n = 40) (median overall survival: 194 days vs. 378 days; p = 0.0010, PD rate: 70.6% vs. 20.0%; p = 0.0003, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

ABSTRACT

Background & aims: We evaluated the relationship between the early clinical response after 2 weeks of sorafenib therapy and the outcomes and anti-tumor response in patients with advanced hepatocellular carcinoma.

Methods: Fifty-seven patients who had intrahepatic hypervascular hepatocellular carcinoma and Child-Pugh (CP) class A disease at baseline were enrolled in this prospective, multicenter, observational, non-interventional study. As an early clinical response after 2 weeks of sorafenib therapy, changes in intra-tumor blood flow on contrast-enhanced computed tomography (CE-CT), alpha-fetoprotein (AFP) levels, and remnant liver function were investigated.

Results: After 2 weeks of sorafenib therapy, there were 26 patients (45.6%) without disappearance of arterial tumor enhancement on CE-CT, 15 patients (26.3%) with an AFP ratio of >1.2, and seven patients (12.3%) with two or more increments in the CP score. Multivariate analysis showed that the absence of disappearance of arterial tumor enhancement on CE-CT, AFP ratio of >1.2, and two or more increments in the CP score after 2 weeks of sorafenib therapy were significant and independent predictors of worse survival. Upon scoring these three variables as "poor prognostic factors", patients with poor prognostic score 4, 3 or 2 (n = 17) had significantly worse outcomes and a significantly higher progressive disease (PD) rate based on modified Response Evaluation Criteria in Solid Tumors at 6 weeks after sorafenib therapy than those with poor prognostic score 1 or 0 (n = 40) (median overall survival: 194 days vs. 378 days; p = 0.0010, PD rate: 70.6% vs. 20.0%; p = 0.0003, respectively).

Conclusions: Changes in intra-tumor blood flow on CE-CT, AFP levels, and remnant liver function after 2 weeks of sorafenib therapy may be useful for predicting the outcomes and anti-tumor response to sorafenib in patients with advanced hepatocellular carcinoma.

No MeSH data available.


Related in: MedlinePlus

Cumulative overall survival according to changes in alpha-fetoprotein level.The median overall survival was significantly shorter in the high alpha-fetoprotein (AFP) ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4589320&req=5

pone.0138776.g003: Cumulative overall survival according to changes in alpha-fetoprotein level.The median overall survival was significantly shorter in the high alpha-fetoprotein (AFP) ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).

Mentions: The patients were subdivided into two groups: (1) patients with an AFP ratio of ≤1.2 (the low AFP ratio group) and (2) patients with an AFP ratio of >1.2 (the high AFP ratio group) at 2 weeks after the start of sorafenib therapy. There were 42 patients (73.7%) in the low AFP ratio group and 15 patients (26.3%) in the high AFP ratio group. Cumulative OS in the two groups according to changes in AFP level is shown in Fig 3. The median OS was significantly shorter in the high AFP ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).


Early Clinical Response after 2 Weeks of Sorafenib Therapy Predicts Outcomes and Anti-Tumor Response in Patients with Advanced Hepatocellular Carcinoma.

Kuzuya T, Ishigami M, Ishizu Y, Honda T, Hayashi K, Katano Y, Hirooka Y, Ishikawa T, Nakano I, Goto H - PLoS ONE (2015)

Cumulative overall survival according to changes in alpha-fetoprotein level.The median overall survival was significantly shorter in the high alpha-fetoprotein (AFP) ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4589320&req=5

pone.0138776.g003: Cumulative overall survival according to changes in alpha-fetoprotein level.The median overall survival was significantly shorter in the high alpha-fetoprotein (AFP) ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).
Mentions: The patients were subdivided into two groups: (1) patients with an AFP ratio of ≤1.2 (the low AFP ratio group) and (2) patients with an AFP ratio of >1.2 (the high AFP ratio group) at 2 weeks after the start of sorafenib therapy. There were 42 patients (73.7%) in the low AFP ratio group and 15 patients (26.3%) in the high AFP ratio group. Cumulative OS in the two groups according to changes in AFP level is shown in Fig 3. The median OS was significantly shorter in the high AFP ratio group than in the low AFP ratio group (170 days vs. 340 days; p = 0.0098).

Bottom Line: After 2 weeks of sorafenib therapy, there were 26 patients (45.6%) without disappearance of arterial tumor enhancement on CE-CT, 15 patients (26.3%) with an AFP ratio of >1.2, and seven patients (12.3%) with two or more increments in the CP score.Multivariate analysis showed that the absence of disappearance of arterial tumor enhancement on CE-CT, AFP ratio of >1.2, and two or more increments in the CP score after 2 weeks of sorafenib therapy were significant and independent predictors of worse survival.Upon scoring these three variables as "poor prognostic factors", patients with poor prognostic score 4, 3 or 2 (n = 17) had significantly worse outcomes and a significantly higher progressive disease (PD) rate based on modified Response Evaluation Criteria in Solid Tumors at 6 weeks after sorafenib therapy than those with poor prognostic score 1 or 0 (n = 40) (median overall survival: 194 days vs. 378 days; p = 0.0010, PD rate: 70.6% vs. 20.0%; p = 0.0003, respectively).

View Article: PubMed Central - PubMed

Affiliation: Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.

ABSTRACT

Background & aims: We evaluated the relationship between the early clinical response after 2 weeks of sorafenib therapy and the outcomes and anti-tumor response in patients with advanced hepatocellular carcinoma.

Methods: Fifty-seven patients who had intrahepatic hypervascular hepatocellular carcinoma and Child-Pugh (CP) class A disease at baseline were enrolled in this prospective, multicenter, observational, non-interventional study. As an early clinical response after 2 weeks of sorafenib therapy, changes in intra-tumor blood flow on contrast-enhanced computed tomography (CE-CT), alpha-fetoprotein (AFP) levels, and remnant liver function were investigated.

Results: After 2 weeks of sorafenib therapy, there were 26 patients (45.6%) without disappearance of arterial tumor enhancement on CE-CT, 15 patients (26.3%) with an AFP ratio of >1.2, and seven patients (12.3%) with two or more increments in the CP score. Multivariate analysis showed that the absence of disappearance of arterial tumor enhancement on CE-CT, AFP ratio of >1.2, and two or more increments in the CP score after 2 weeks of sorafenib therapy were significant and independent predictors of worse survival. Upon scoring these three variables as "poor prognostic factors", patients with poor prognostic score 4, 3 or 2 (n = 17) had significantly worse outcomes and a significantly higher progressive disease (PD) rate based on modified Response Evaluation Criteria in Solid Tumors at 6 weeks after sorafenib therapy than those with poor prognostic score 1 or 0 (n = 40) (median overall survival: 194 days vs. 378 days; p = 0.0010, PD rate: 70.6% vs. 20.0%; p = 0.0003, respectively).

Conclusions: Changes in intra-tumor blood flow on CE-CT, AFP levels, and remnant liver function after 2 weeks of sorafenib therapy may be useful for predicting the outcomes and anti-tumor response to sorafenib in patients with advanced hepatocellular carcinoma.

No MeSH data available.


Related in: MedlinePlus