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Expert Rev Gastroenterol Hepatol ; 12(1): 99-107, 2018 Jan.
Article in English | MEDLINE | ID: mdl-29124987

ABSTRACT

BACKGROUND: Sorafenib is the standard of care, first line treatment for advanced HCC. This study aims to evaluate real-life efficacy and safety of sorafenib in Egyptian patients with Hepatocellular carcinoma (HCC). METHODS: This retrospective cohort study was conducted in the medical oncology department at Maadi Armed Forces Medical Compound. Patients with advanced HCC who received sorafenib between January and December 2015 were included (130 patients). RESULTS: The median overall survival of patients with HCC treated with sorafenib was 5 months (CI: 4.166-5.834), and progression free survival was 4 months (CI: 3.479-4.521). Disease control rate was 45.44% with 2 patients experiencing complete remission (1.2%). The adverse events rate was 76.1% for toxicities of all grades; with hand and foot syndrome being the most common (32.3% of any grade) and liver dysfunction the most common grade III toxicity (13.8%). Treatment was stopped for radiological progression based on modified RECIST criteria in 47 patients (36.3%), 18 patients stopped the treatment for intolerable toxicity. At the end of treatment upon radiological progression, 51 patients (39.2%) were still classified as Child A class of cirrhosis. CONCLUSION: Sorafenib use should be limited to patients with Child A, PS 0-1, and low disease burden.


Subject(s)
Antineoplastic Agents/therapeutic use , Carcinoma, Hepatocellular/drug therapy , Liver Neoplasms/drug therapy , Niacinamide/analogs & derivatives , Phenylurea Compounds/therapeutic use , Protein Kinase Inhibitors/therapeutic use , Adult , Aged , Aged, 80 and over , Antineoplastic Agents/adverse effects , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/enzymology , Carcinoma, Hepatocellular/mortality , Clinical Decision-Making , Disease Progression , Disease-Free Survival , Egypt , Female , Hand-Foot Syndrome/etiology , Humans , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/enzymology , Liver Neoplasms/mortality , Male , Middle Aged , Niacinamide/adverse effects , Niacinamide/therapeutic use , Patient Selection , Phenylurea Compounds/adverse effects , Protein Kinase Inhibitors/adverse effects , Retrospective Studies , Risk Factors , Sorafenib , Time Factors , Treatment Outcome , Young Adult
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