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Sorafenib versus cytotoxic chemotherapy for patients with advanced hepatocellular carcinoma: a retrospective, single-institution study

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Summary

Background Prior to the 2008 advent of sorafenib, traditional cytotoxic agents were the therapeutic mainstay for patients with advanced hepatocellular carcinoma (HCC). We thus undertook a clinical study of sorafinib and conventional cytotoxic therapy for HCC, comparing efficacy and safety. Methods From January, 2002 to December, 2009, 173 patients with unresectable HCC were reviewed retrospectively. Among them, 44 (25.4%) had been treated with sorafenib, and the remainder had received cytotoxic therapy (CTX). We evaluated objective response rate (ORR), progression free survival (PFS), overall survival (OS), and toxicity profiles. Results Median OS of sorafinib was 23.0 weeks (95% CI, 8.1–37.9) vs 43.6 weeks (95% CI, 34.0–53.2) for CTX. Likewise, median PFS was 11.1 weeks (95% CI, 6.5–15.8) vs 12.4 weeks (95% CI, 8.1–16.7) for sorafenib and CTX, respectively. Neither parameter differed significantly (OS, p = 0.105; PFS, p = 0.496). ORR and disease control rate for sorafenib were 2.3% and 52.3% vs 6.2% and 43.4% for CTX. CTX-treated patients experienced more Grade 3/4 neutropenia (19.7% vs 0% for sorafenib), while sorafenib therapy was more often linked to dermatologic toxicities (all grades), such as hand-foot skin reaction, rash, and pruritus. Conclusion Although sorafenib has become the treatment of choice for advanced HCC, there are still unsettled issues regarding the optimal use of sorafenib. Our analysis indicates that conventional CTX can be another option of treatment for advanced HCC. To improve clinical outcomes, further prospective investigations which define the role of CTX are needed.

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Authors and Affiliations

  1. Division of Oncology, Department of Internal Medicine, Yonsei University College of Medicine, 250 Seongsanno, , Seodaemun-gu,, Seoul, 120-752, South Korea

    Soohyeon Lee, Sang Hyun Yoon & Hye Jin Choi

  2. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea

    Jun Yong Park, Do Young Kim, Sang Hoon Ahn & Kwang-Hyub Han

  3. Yonsei Liver Cancer Special Clinic, Severance Hosptial, Seoul, South Korea

    Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han & Hye Jin Choi

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  1. Soohyeon Lee
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  2. Sang Hyun Yoon
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  3. Jun Yong Park
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  4. Do Young Kim
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  5. Sang Hoon Ahn
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  7. Hye Jin Choi
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Correspondence to Hye Jin Choi.

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Lee, S., Yoon, S.H., Park, J.Y. et al. Sorafenib versus cytotoxic chemotherapy for patients with advanced hepatocellular carcinoma: a retrospective, single-institution study. Invest New Drugs 30, 1150–1157 (2012). https://doi.org/10.1007/s10637-011-9634-4

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  • DOI: https://doi.org/10.1007/s10637-011-9634-4

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