Sorafenib is associated with a reduced rate of tumour growth and liver function deterioration in HCV-induced hepatocellular carcinoma.

Kolamunnage-Dona, Ruwanthi, Berhane, Sarah, Potts, Harry, Williams, Edward H, Tanner, James, Janowitz, Tobias, Hoare, Matthew and Johnson, Philip (2021) Sorafenib is associated with a reduced rate of tumour growth and liver function deterioration in HCV-induced hepatocellular carcinoma. Journal of hepatology. ISSN 1600-0641. This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs

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Abstract

PURPOSE

Sorafenib has been the standard of care for patients with advanced hepatocellular carcinoma and although immunotherapeutic approaches are now challenging this position, it retains an advantage in HCV seropositive patients. We aimed to quantify the rate of tumour progression in patients receiving sorafenib and relate this figure to survival, both overall, and according to viral status.

PATIENTS AND METHODS

Using serial data from an international clinical trial we applied a joint model to combine survival and progression over time so as to estimate the rate of tumour growth as assessed by tumour burden and serum AFP, and the impact of treatment on liver function.

RESULTS

High tumour burden at baseline was associated with an increased risk of death. In patients still alive at the end of the study, the progression in relation to tumour burden was very low compared to those who died within the study. Overall, the change in mean tumour burden was 0.12 mm per day or an absolute growth rate of 3.6mm/month. Median doubling time (DT) was 665 days. For those who progressed above 0.12mm per day or 12% rate, median survival was 234 days compared to 384 days if the rate was below 12%. Tumour growth rate and serum AFP rise were significantly lower in those who were HCV seropositive as was the rate of decline in liver function. These results were replicated in two independent patient groups.

CONCLUSION

Our analysis suggests that sorafenib treatment is associated with improved survival in patients with advanced hepatocellular carcinoma mainly by decreasing the rate of tumour growth and liver function deterioration among patients with HCV infection.

LAY SUMMARY

Among patients receiving sorafenib for advanced hepatocellular carcinoma the rate of tumour growth (as assessed by changes in tumour size and the biomarker AFP) and the deterioration of liver function is less in those who have the Hepatitis C virus, than those who do not.

CLINICAL TRIALS DATA

The clinical trials data belongs to Bristol Myers Squibb and AbbVie Inc. The clinical data belongs to Cambridge University Hospitals NHS Foundation Trust.

Item Type: Article
Additional Information: This article is available to all UHB staff and students via ASK Discovery tool http://tinyurl.com/z795c8c by using their UHB Athens login IDs
Subjects: QZ Pathology. Oncology
W Public health. Health statistics. Occupational health. Health education
WN Medical imaging. Radiology
Divisions: Planned IP Care > Oncology and Clinical Haematology
Related URLs:
Depositing User: Jamie Edgar
Date Deposited: 04 Jun 2021 15:02
Last Modified: 04 Jun 2021 15:02
URI: http://www.repository.uhblibrary.co.uk/id/eprint/4398

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