The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma
Article first published online: 23 MAY 2011
© 2011 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 34, Issue 2, pages 205–213, July 2011
How to Cite
Cabrera, R., Pannu, D. S., Caridi, J., Firpi, R. J., Soldevila-Pico, C., Morelli, G., Clark, V., Suman, A., George Jr., T. J. and Nelson, D. R. (2011), The combination of sorafenib with transarterial chemoembolisation for hepatocellular carcinoma. Alimentary Pharmacology & Therapeutics, 34: 205–213. doi: 10.1111/j.1365-2036.2011.04697.x
- Issue published online: 16 JUN 2011
- Article first published online: 23 MAY 2011
- Publication data Submitted 25 March 2011 First decision 8 April 2011 Resubmitted 22 April 2011 Accepted 22 April 2011 EV Pub Online 23 May 2011
Aliment Pharmacol Ther 2011; 34: 205–213
Background Standard of practice involves using transarterial therapy for multifocal hepatocellular carcinoma (HCC) alone and sorafenib only for more advanced HCC, but the sorafenib and transarterial therapy combination may provide greater efficacy.
Aim To evaluate the safety and efficacy of concurrent sorafenib and transarterial therapy in HCC.
Methods Consecutive cases of HCC were treated with sorafenib and transarterial therapy, receiving sorafenib 2 to 4 weeks before transarterial therapy. Baseline clinical parameters, adverse events (AEs) and survival were collected.
Results A total of 47 patients received sorafenib and transarterial therapy. The majority of the patients were male (70%) with HCV (60%), median age of 60 years, good performance status (0–1), stable cirrhosis (Child: A 72%; B 28%), unresectable tumour (stage: B 81%; C 19%) and median AFP of 24 ng/mL. Median follow-up was 12 months and median time on sorafenib was 6 months. LC Bead TACE was used with a median frequency of 3. The majority of the patients (89%) experienced AEs. The most common AEs were fatigue (51%), hand-foot skin reaction (51%) and diarrhoea (43%). Grade 3 and 4 AEs included fatigue (13%) and hand-foot skin reaction (26%). Most patients required a dose reduction (66%). The main AE related to transarterial therapy was post-TACE syndrome (23%). The disease control rate was 68% at 6 months. Overall median survival rate was 18.5 months (95% CI 16.1–20.9 months).
Conclusion Concurrent sorafenib and transarterial therapy is overall safe with no unexpected side effects and encouraging efficacy that warrants further study.