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Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database.
Alghamdi, Mohammed A; Amaro, Carla P; Lee-Ying, Richard; Sim, Hao-Wen; Samwi, Haider; Chan, Kelvin K; Knox, Jennifer J; Ko, Yoo-Joung; Swiha, Mina; Batuyong, Eugene; Romagnino, Adriana; Cheung, Winson Y; Tam, Vincent C.
Afiliação
  • Alghamdi MA; Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
  • Amaro CP; College of Medicine, King Saud University, Riyadh, Saudi Arabia.
  • Lee-Ying R; Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
  • Sim HW; Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
  • Samwi H; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
  • Chan KK; St. Michael's Hospital, University of Toronto, Toronto, ON, Canada.
  • Knox JJ; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada.
  • Ko YJ; Canadian Centre for Applied Research in Cancer Control, Toronto, ON, Canada.
  • Swiha M; Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada.
  • Batuyong E; Sunnybrook Odette Cancer Centre, Toronto, ON, Canada.
  • Romagnino A; University of Western Ontario, London, ON, Canada.
  • Cheung WY; Menoufia University, Shebin El Kom, Egypt.
  • Tam VC; Tom Baker Cancer Centre, University of Calgary, Calgary, AB, Canada.
Cancer Med ; 9(14): 4918-4928, 2020 07.
Article em En | MEDLINE | ID: mdl-32529797
BACKGROUND: Sorafenib has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC), however, full dose can be difficult to tolerate. The aim of this study was to determine whether sorafenib starting dose and mean dose intensity affect survival. METHODS: Patients treated with sorafenib for HCC from January 2008 to July 2016 in several Canadian provinces were included and retrospectively analyzed. The primary end point was overall survival (OS) of patients starting on sorafenib full dose compared to reduced dose. Secondary analysis compared OS with different mean dose-intensity groups. Survival outcomes were assessed with Kaplan-Meier curves and Cox proportional hazards models. A propensity score analysis was performed to account for treatment bias and confounding. RESULTS: Of 681 patients included, sorafenib was started at full dose in 289 patients (42%). Median survival for starting full and reduced dose was 9.4 months and 8.9 months (P = .15) respectively. After propensity score matching and adjusting for potential confounders there was still no difference in survival (HR 0.8, 95% CI, 0.61-1.06, P = .12). Almost half of the patients (45%) received a dose intensity < 50%. Median survival for mean dose intensity > 75%, 50%-75%, and < 50% were 9.5 months, 12.9 months, and 7.1 months (P = .005) respectively. In multivariable models, starting dose(HR 1.16, 95% CI 0.93-1.44, P = .180) and mean dose intensity were not associated with survival. CONCLUSIONS: Starting HCC patients on a reduced dose of sorafenib compared to full dose may not compromise survival. Mean dose-intensity of sorafenib may also not affect survival.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Hepatocelular / Sorafenibe / Neoplasias Hepáticas / Antineoplásicos Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Cancer Med Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Canadá

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Carcinoma Hepatocelular / Sorafenibe / Neoplasias Hepáticas / Antineoplásicos Tipo de estudo: Clinical_trials / Prognostic_studies Limite: Female / Humans / Male / Middle aged País/Região como assunto: America do norte Idioma: En Revista: Cancer Med Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Canadá