Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma
The predictors of response and survival in patients with hepatocellular carcinoma (HCC) receiving regorafenib remain unclear. This study aimed to delineate the determinants of response and survival after regorafenib and evaluate post-progression treatment and outcomes. We retrospectively enrolled 10...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-04-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/8/2014 |
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| author | I-Cheng Lee Yee Chao Pei-Chang Lee San-Chi Chen Chen-Ta Chi Chi-Jung Wu Kuo-Cheng Wu Ming-Chih Hou Yi-Hsiang Huang |
| author_facet | I-Cheng Lee Yee Chao Pei-Chang Lee San-Chi Chen Chen-Ta Chi Chi-Jung Wu Kuo-Cheng Wu Ming-Chih Hou Yi-Hsiang Huang |
| author_sort | I-Cheng Lee |
| collection | DOAJ |
| description | The predictors of response and survival in patients with hepatocellular carcinoma (HCC) receiving regorafenib remain unclear. This study aimed to delineate the determinants of response and survival after regorafenib and evaluate post-progression treatment and outcomes. We retrospectively enrolled 108 patients with unresectable HCC receiving regorafenib after sorafenib failure. Progression-free survival (PFS), overall survival (OS), post-progression survival (PPS) and post-progression treatments were evaluated. The median PFS, OS and PPS were 3.1, 13.1 and 10.3 months, respectively. Achieving disease control by prior sorafenib, early AFP reduction and hand-foot skin reaction (HFSR) were associated with significantly better radiologic responses. By multivariate analysis, the time to progression on prior sorafenib, HFSR and early AFP reduction were associated with PFS; ALBI grade, portal vein invasion, HFSR and early AFP reduction were associated with OS. ALBI grade at disease progression, main portal vein invasion, high tumor burden and next-line therapy were associated with PPS. The median PPS was 12 months in patients who received next-line therapy, and the PPS was comparable between patients who received next-line targeted agents and immunotherapy. In conclusion, survival outcomes of regorafenib for HCC have improved in the era of multi-line sequential therapy. Preserved liver function and next-line therapy are important prognostic factors after regorafenib failure. |
| first_indexed | 2024-03-09T11:03:16Z |
| format | Article |
| id | doaj.art-5e5b262154e84aa696c024408bb5fed2 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T11:03:16Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5e5b262154e84aa696c024408bb5fed22023-12-01T01:08:38ZengMDPI AGCancers2072-66942022-04-01148201410.3390/cancers14082014Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular CarcinomaI-Cheng Lee0Yee Chao1Pei-Chang Lee2San-Chi Chen3Chen-Ta Chi4Chi-Jung Wu5Kuo-Cheng Wu6Ming-Chih Hou7Yi-Hsiang Huang8Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanCancer Center, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanCancer Center, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanDivision of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei 11217, TaiwanThe predictors of response and survival in patients with hepatocellular carcinoma (HCC) receiving regorafenib remain unclear. This study aimed to delineate the determinants of response and survival after regorafenib and evaluate post-progression treatment and outcomes. We retrospectively enrolled 108 patients with unresectable HCC receiving regorafenib after sorafenib failure. Progression-free survival (PFS), overall survival (OS), post-progression survival (PPS) and post-progression treatments were evaluated. The median PFS, OS and PPS were 3.1, 13.1 and 10.3 months, respectively. Achieving disease control by prior sorafenib, early AFP reduction and hand-foot skin reaction (HFSR) were associated with significantly better radiologic responses. By multivariate analysis, the time to progression on prior sorafenib, HFSR and early AFP reduction were associated with PFS; ALBI grade, portal vein invasion, HFSR and early AFP reduction were associated with OS. ALBI grade at disease progression, main portal vein invasion, high tumor burden and next-line therapy were associated with PPS. The median PPS was 12 months in patients who received next-line therapy, and the PPS was comparable between patients who received next-line targeted agents and immunotherapy. In conclusion, survival outcomes of regorafenib for HCC have improved in the era of multi-line sequential therapy. Preserved liver function and next-line therapy are important prognostic factors after regorafenib failure.https://www.mdpi.com/2072-6694/14/8/2014hepatocellular carcinomasorafenibregorafenibprogression-free survivaloverall survivalpost-progression survival |
| spellingShingle | I-Cheng Lee Yee Chao Pei-Chang Lee San-Chi Chen Chen-Ta Chi Chi-Jung Wu Kuo-Cheng Wu Ming-Chih Hou Yi-Hsiang Huang Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma Cancers hepatocellular carcinoma sorafenib regorafenib progression-free survival overall survival post-progression survival |
| title | Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma |
| title_full | Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma |
| title_fullStr | Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma |
| title_full_unstemmed | Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma |
| title_short | Determinants of Survival and Post-Progression Outcomes by Sorafenib–Regorafenib Sequencing for Unresectable Hepatocellular Carcinoma |
| title_sort | determinants of survival and post progression outcomes by sorafenib regorafenib sequencing for unresectable hepatocellular carcinoma |
| topic | hepatocellular carcinoma sorafenib regorafenib progression-free survival overall survival post-progression survival |
| url | https://www.mdpi.com/2072-6694/14/8/2014 |
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