Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma
Background: The response rate to sorafenib is limited for unresectable hepatocellular carcinoma (HCC). Little is known about the long-term outcomes of objective responders. The role of second-line therapies on the survival of sorafenib-responders is unclear. We aimed to delineate the long-term outco...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-05-01
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| Series: | Therapeutic Advances in Medical Oncology |
| Online Access: | https://doi.org/10.1177/17588359221099401 |
| _version_ | 1811237402147028992 |
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| author | Kuo-Wei Huang Pei-Chang Lee Yee Chao Chien-Wei Su I-Cheng Lee Keng-Hsin Lan Chi-Jen Chu Yi-Ping Hung San-Chi Chen Ming-Chih Hou Yi-Hsiang Huang |
| author_facet | Kuo-Wei Huang Pei-Chang Lee Yee Chao Chien-Wei Su I-Cheng Lee Keng-Hsin Lan Chi-Jen Chu Yi-Ping Hung San-Chi Chen Ming-Chih Hou Yi-Hsiang Huang |
| author_sort | Kuo-Wei Huang |
| collection | DOAJ |
| description | Background: The response rate to sorafenib is limited for unresectable hepatocellular carcinoma (HCC). Little is known about the long-term outcomes of objective responders. The role of second-line therapies on the survival of sorafenib-responders is unclear. We aimed to delineate the long-term outcomes and the role of subsequent treatment after responding to sorafenib. Methods: From September 2012 to December 2019, 922 patients who received sorafenib treatment for unresectable HCC were retrospectively reviewed. Of these, 21 (2.3%) achieved a complete response (CR) and 54 (5.9%) had a partial response (PR) based on mRECIST criteria. Factors associated with survivals were analyzed. Results: During the median follow-up of 35.3 months, the median duration of response was 18.3 months (range: 2.3–45.5) for patients achieving CR and 10.0 months (range: 1.9–60.3) for PR. The median overall survival (OS) was 39.5 months [95% confidence interval (CI): 28.4–50.5] including values not yet estimable for CR and 25.8 months for PR. Patients who experienced treatment-related adverse events (TRAEs) had better median OS than those without (44.9 versus 18.1 months, p = 0.003). Eventually, 53 patients developed tumor progression; 30 patients received second-line systemic treatment including nivolumab ( n = 8), regorafenib ( n = 15), and chemotherapy ( n = 7). Sorafenib–nivolumab sequential therapy provided the best median OS versus sorafenib–regorafenib and sorafenib–chemotherapy in these patients (55.8, 39.5, and 25.5 months), respectively. Conclusions: The response is durable for advanced HCC patients with CR or PR to sorafenib. Subsequent immunotherapy seems to provide the best survival. This information is important for characterizing outcomes of sorafenib-responders and the choice of sequential treatment. |
| first_indexed | 2024-04-12T12:23:47Z |
| format | Article |
| id | doaj.art-e8a36f76466a485dbb376ee5b5bdf935 |
| institution | Directory Open Access Journal |
| issn | 1758-8359 |
| language | English |
| last_indexed | 2024-04-12T12:23:47Z |
| publishDate | 2022-05-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Medical Oncology |
| spelling | doaj.art-e8a36f76466a485dbb376ee5b5bdf9352022-12-22T03:33:13ZengSAGE PublishingTherapeutic Advances in Medical Oncology1758-83592022-05-011410.1177/17588359221099401Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinomaKuo-Wei HuangPei-Chang LeeYee ChaoChien-Wei SuI-Cheng LeeKeng-Hsin LanChi-Jen ChuYi-Ping HungSan-Chi ChenMing-Chih HouYi-Hsiang HuangBackground: The response rate to sorafenib is limited for unresectable hepatocellular carcinoma (HCC). Little is known about the long-term outcomes of objective responders. The role of second-line therapies on the survival of sorafenib-responders is unclear. We aimed to delineate the long-term outcomes and the role of subsequent treatment after responding to sorafenib. Methods: From September 2012 to December 2019, 922 patients who received sorafenib treatment for unresectable HCC were retrospectively reviewed. Of these, 21 (2.3%) achieved a complete response (CR) and 54 (5.9%) had a partial response (PR) based on mRECIST criteria. Factors associated with survivals were analyzed. Results: During the median follow-up of 35.3 months, the median duration of response was 18.3 months (range: 2.3–45.5) for patients achieving CR and 10.0 months (range: 1.9–60.3) for PR. The median overall survival (OS) was 39.5 months [95% confidence interval (CI): 28.4–50.5] including values not yet estimable for CR and 25.8 months for PR. Patients who experienced treatment-related adverse events (TRAEs) had better median OS than those without (44.9 versus 18.1 months, p = 0.003). Eventually, 53 patients developed tumor progression; 30 patients received second-line systemic treatment including nivolumab ( n = 8), regorafenib ( n = 15), and chemotherapy ( n = 7). Sorafenib–nivolumab sequential therapy provided the best median OS versus sorafenib–regorafenib and sorafenib–chemotherapy in these patients (55.8, 39.5, and 25.5 months), respectively. Conclusions: The response is durable for advanced HCC patients with CR or PR to sorafenib. Subsequent immunotherapy seems to provide the best survival. This information is important for characterizing outcomes of sorafenib-responders and the choice of sequential treatment.https://doi.org/10.1177/17588359221099401 |
| spellingShingle | Kuo-Wei Huang Pei-Chang Lee Yee Chao Chien-Wei Su I-Cheng Lee Keng-Hsin Lan Chi-Jen Chu Yi-Ping Hung San-Chi Chen Ming-Chih Hou Yi-Hsiang Huang Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma Therapeutic Advances in Medical Oncology |
| title | Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| title_full | Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| title_fullStr | Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| title_full_unstemmed | Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| title_short | Durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| title_sort | durable objective response to sorafenib and role of sequential treatment in unresectable hepatocellular carcinoma |
| url | https://doi.org/10.1177/17588359221099401 |
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