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 remnant liver function.The median overall survival was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0138776.g004: Cumulative overall survival according to changes in remnant liver function.The median overall survival was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).

Mentions: The patients were subdivided into two groups: (1) patients with 2 or more increments in the CP score at 2 weeks after sorafenib administration (liver function deterioration group) and (2) patients with less than 2 increments in the CP score (non-liver function deterioration group). There were seven patients (three patients with pretreatment CP score of 5; four patients with pretreatment CP score of 6) (12.3%) in the liver function deterioration group and 50 patients (87.7%) in the non-liver function deterioration group. Cumulative OS in the two groups according to changes in remnant liver function is shown in Fig 4. The median OS was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).


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 remnant liver function.The median overall survival was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0138776.g004: Cumulative overall survival according to changes in remnant liver function.The median overall survival was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).
Mentions: The patients were subdivided into two groups: (1) patients with 2 or more increments in the CP score at 2 weeks after sorafenib administration (liver function deterioration group) and (2) patients with less than 2 increments in the CP score (non-liver function deterioration group). There were seven patients (three patients with pretreatment CP score of 5; four patients with pretreatment CP score of 6) (12.3%) in the liver function deterioration group and 50 patients (87.7%) in the non-liver function deterioration group. Cumulative OS in the two groups according to changes in remnant liver function is shown in Fig 4. The median OS was significantly shorter in the liver function deterioration group than in the non-liver function deterioration group (96 days vs. 263 days; p = 0.0111).

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