Efficacy of Sorafenib for Advanced Hepatocellular Carcinoma and Prognostic Factors.

Background/aims: Sorafenib, a drug that inhibits Raf serine/threonine kinases mediating cell proliferation and receptor tyrosine kinases involved in angiogenesis, is approved for treatment of advanced hepatocellular carcinoma. The study aims to evaluate the efficacy and analyze the prognostic factors of sorafenib treatment in patients with advanced hepatocellular carcinoma (HCC).

Methodology: Consecutive cases of HCC were treated with sorafenib (400 mg, Bid). Baseline clinical parameters, adverse events and survival were collected.

Results: A total of 60 patients received sorafenib and transarterial therapy. There was no CR; 2 (3.3%) patients achieved partial response, but 30 patients (50.0%) achieved stable disease. The median follow-up time was 16 months. The median OS and median TTP were 13.6 months and 4.4 months respectively. The common adverse events were dermal reaction (60.0%, 36/60), diarrhea (46.7.0%, 28/60), hypertension (5.0%, 3/60), hair loss (16.7%, 10/60), myelosuppression (20.0%, 12/60), and liver dysfunction (25.0%, 15/60). In most patients, these side effects were mild-to-moderate, and alleviated remarkably after symptomatic treatment. The patients with lower tumor burden and without extrahepatic spread had better prognosis.

Conclusions: Soafenib is effective for unresectable primary HCC with tolerable toxicity. Tumor stage is a predominant prognostic factor.