Sorafenib use in elderly patients with hepatocellular carcinoma: caution about use of platelet aggregation inhibitors.
Cancer Chemother Pharmacol
; 75(1): 215-9, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25477009
ABSTRACT
PURPOSE:
Sorafenib is the standard of care for advanced hepatocellular carcinoma (HCC). The peak incidence of HCC is around 70 years. We aimed to evaluate safety and efficacy of sorafenib in the elderly population.METHODS:
We retrospectively reviewed data from patients treated with sorafenib for HCC at our institution. We compared safety and efficacy data across different age groups.RESULTS:
Since 2005, 129 patients were treated, 78 (60.5 %) were <70 years old and 51 (39.5 %) were ≥70. The frequency of dose reduction was similar between the two groups (48.7 vs. 58.8 %), as was the occurrence of severe toxicities (41.0 vs. 51.0 %) and hospitalization due to toxicity (9.0 vs. 13.7 %). However, asthenia and bleeding were more frequent in the elderly. The higher frequency of bleeding was explained by concomitant antiplatelet treatments, and major asthenia was frequent in PS1 elderly patients. There was a trend toward less frequent interruption of treatment in the younger group (25.6 vs. 39.2 %) and significantly less frequent definitive discontinuation of treatment due to toxicity (24.4 vs. 45.1 %). Median progression-free survival was 5.6 months in both age groups, while median overall survival was 9.6 months in the younger age group and 12.6 months in the older age group.CONCLUSION:
Sorafenib showed similar results in terms of safety and efficacy in the elderly and younger HCC populations. Careful baseline evaluation is needed for patient's selection in the elderly population, including discussion about antiplatelet therapy discontinuation and caution in PS1 patients, as well as active management of toxicity.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Compostos de Fenilureia
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Envelhecimento
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Inibidores da Agregação Plaquetária
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Niacinamida
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Carcinoma Hepatocelular
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Trombose Venosa
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Neoplasias Hepáticas
/
Antineoplásicos
Tipo de estudo:
Incidence_studies
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Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged80
País como assunto:
Europa
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article