Adoption of Sorafenib for the Treatment of Advanced-Stage Hepatocellular Carcinoma in Oncology Practices in the United States

Helen M. Parsons, Quyen Chu, Jordan J. Karlitz, Jennifer L. Stevens, Linda C. Harlan

Research output: Contribution to journalArticlepeer-review

12 Scopus citations

Abstract

Background: The adoption of sorafenib into oncology practice as a first-line systemic treatment for advanced hepatocellular carcinoma (HCC) is not well understood. We examined sorafenib use since Food and Drug Administration (FDA) approval in 2007 and associated survival for individuals diagnosed with advanced HCC, conducting a population-based evaluation of treatment patterns and outcomes for this newly approved drug in the US over time. Methods: We identified individuals diagnosed with Barcelona Clinic Liver Cancer Stage C from the 2007 and 2012 National Cancer Institute Patterns of Care study. We examined trends in use as well as patient and clinical factors associated with receiving sorafenib using multivariate logistic regression analysis. We then evaluated the association between sorafenib use and overall hazard of death using multivariate Cox proportional hazards regression. Results: Among 550 individuals diagnosed with advanced HCC, we found no significant increase in the proportion of patients treated with sorafenib from 2007 to 2012 (26.3 vs. 30.4%). After adjusting for patient and clinical characteristics, non-Hispanic Blacks (compared to non-Hispanic Whites) and those with a lower Child-Pugh score remained more likely to receive sorafenib. Individuals receiving systemic chemotherapy only, radiation therapy only, or no treatment at all experienced a higher risk of death than those treated with sorafenib, while those receiving a transplant experienced a lower risk of death. Conclusions: Sorafenib has not been widely adopted into oncology practice since FDA approval for advanced HCC. Few factors apart from Child-Pugh score and race/ethnicity predict sorafenib use in clinical practice, although sorafenib treatment is associated with a lower risk of death.

Original languageEnglish (US)
Pages (from-to)216-226
Number of pages11
JournalLiver Cancer
Volume6
Issue number3
DOIs
StatePublished - Jun 1 2017

Bibliographical note

Funding Information:
Dr. Parsons receives support from an NCI Cancer Prevention and Control Career Development Award (K07CA175063). Supported by NCI Contracts HHSN261201000024C, HHSN261201000025C, HSC261201000032C, HHSN261201000027C, HHSN261201000026C, HHSN261201000140C, HHSN261201000037C, HHSN261201000033C, HHSN261201000034C, HHSN261201000035C, HHSN261201000029C, HHSN261201000031C, HHSN261201000028C, and HHSN261201000030C. This article is a US Government work and, as such, is in the public domain in the United States of America.

Funding Information:
Dr. Parsons receives support from an NCI Cancer Prevention and Control Career Development Award (K 爃礀CA 猃礃眃爃砃甂I. Supported by NCI Contracts HHSN 球砃猃球爃猃S爃N爃 球爃砃爃猃球球瘀爃C猃, 爃H爃H爃爃球眀C, HSC 球砃猃球爃猃爃爃爃爃甃琀C, HHSN 球砃猃球爃猃爃爃爃爃球礀C, HHSN 球砃猃球球爃爃猃猃爃爃爃爃爃爃猃爃瘃球爀砀CC, , HHSN 球砃猃球爃猃爃爃爃爃甃礀C, HHSN 球砃猃球爃猃爃爃爃爃甃甀C, HHSN 球砃猃猃球球爃爃猃猃爃爃爃爃爃爃爃爃甃甃眀瘀CC,, HHSN 球砃猃球爃猃爃爃爃爃球笀C, HHSN 球砃猃球爃猃爃爃爃爃甃猀C, HHSNS N球 球砃砃猃猃球球爃爃猃猃爃爃爃爃爃爃爃爃球甃稀爀C, Ca.nd HH This article is a US Government work and, as such, is in the public domain in the United States of America.

Publisher Copyright:
© 2017 S. Karger AG, Basel. All rights reserved.

Keywords

  • Hepatocellular carcinoma
  • Policy
  • SEER Program
  • Sorafenib
  • Treatment

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