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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 in the poor prognostic score 4, 3 or 2 and 1 or 0 groups.In the poor prognostic score 4, 3 or 2 groups, the median overall survival was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).
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pone.0138776.g006: Cumulative overall survival in the poor prognostic score 4, 3 or 2 and 1 or 0 groups.In the poor prognostic score 4, 3 or 2 groups, the median overall survival was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).

Mentions: There were 40 patients (70.2%) in the poor prognostic score 1 or 0 group and 17 patients (29.8%) in the poor prognostic score 4, 3 or 2 group after 2 weeks of sorafenib therapy. Cumulative OS in the poor prognostic score 4, 3 or 2 and 1 or 0 groups is shown in Fig 6. In the poor prognostic score 4, 3 or 2 groups, the median OS was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).


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 in the poor prognostic score 4, 3 or 2 and 1 or 0 groups.In the poor prognostic score 4, 3 or 2 groups, the median overall survival was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).
© Copyright Policy
Related In: Results  -  Collection

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

pone.0138776.g006: Cumulative overall survival in the poor prognostic score 4, 3 or 2 and 1 or 0 groups.In the poor prognostic score 4, 3 or 2 groups, the median overall survival was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).
Mentions: There were 40 patients (70.2%) in the poor prognostic score 1 or 0 group and 17 patients (29.8%) in the poor prognostic score 4, 3 or 2 group after 2 weeks of sorafenib therapy. Cumulative OS in the poor prognostic score 4, 3 or 2 and 1 or 0 groups is shown in Fig 6. In the poor prognostic score 4, 3 or 2 groups, the median OS was significantly shorter than that in the poor prognostic score 1 or 0 groups (194 vs. 378 days; p = 0.0010).

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