Sorafenib for Treatment of Hepatocellular Carcinoma: A Survival Analysis from the South American Liver Research Network

James S. Leathers, Domingo Balderramo, John Prieto, Fernando Diehl, Esteban Gonzalez-Ballerga, Melina R. Ferreiro, Enrique Carrera, Fernando Barreyro, Javier Diaz-Ferrer, Dupinder Singh, Angelo Z. Mattos, Flair Carrilho, Jose D. Debes

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Goals:We aim to describe the efficacy, safety profile, and variables associated with survival in patients with hepatocellular carcinoma (HCC) treated with sorafenib in South America.Background:Sorafenib has been shown to improve survival in patients with advanced HCC. There are few data on sorafenib use for HCC in South America.Study:We performed a retrospective analysis of HCC cases treated with sorafenib from 8 medical centers in 5 South American countries, between January 2010 and June 2017. The primary endpoint was overall survival (OS), which was defined as time from sorafenib initiation to death or last follow-up. Risk factors for decreased OS were assessed using Cox proportional hazard regression and log-rank tests.Results:Of 1336 evaluated patients, 127 were treated with sorafenib and were included in the study. The median age of individuals was 65 years (interquartile range, 55 to 71) and 70% were male individuals. Median OS in all patients was 8 months (interquartile range, 2 to 17). Variables associated with survival on multivariate analysis were platelets >/<250,000 mm3 (2 vs. 8 mo, P=0.01) and Barcelona Clinic Liver Cancer (BCLC) stage (A/B, 13 vs. C/D, 6 mo; P=0.04). In a subanalysis of patients with BCLC stage C, platelets >/<250,000 mm3 were also independently associated with survival (2 vs. 5.5 mo, P=0.03). Patients lived longer if they experienced any side effects from sorafenib use (11 vs. 2 mo, P=0.009). Patients who stopped sorafenib because of side effects had shorter survival compared with patients who were able to tolerate side effects and continue treatment (7.5 vs. 13 mo, P=0.01).Conclusions:Pretreatment elevation of platelets and advanced BCLC stage were independently associated with poor survival on sorafenib in a South American cohort.

Original languageEnglish (US)
Pages (from-to)464-469
Number of pages6
JournalJournal of clinical gastroenterology
Volume53
Issue number6
DOIs
StatePublished - Jul 1 2019

Bibliographical note

Funding Information:
Supported by the Doris Duke Charitable Foundation through a grant supporting the Doris Duke International Clinical Research Fel-lowship Program at the University of Minnesota to J.L., and the Robert Wood Johnson Foundation, AFMDP to J.D.D.

Publisher Copyright:
© 2019 Lippincott Williams and Wilkins. All rights reserved.

Keywords

  • South America
  • hepatocellular carcinoma
  • sorafenib
  • survival

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