The Impact of Early Dermatologic Events in the Survival of Patients with Hepatocellular Carcinoma Treated with Sorafenib

• Published in: Annals of hepatology 2017-03, Vol.16 (2), p.263-268
• Main Authors: Branco, Fernanda, Alencar, Regiane S.M, Volt, Fernanda, Sartori, Giovana, Dode, Andressa, Kikuchi, Luciana, Tani, Claudia M, Chagas, Aline L, Pfiffer, Tulio, Hoff, Paulo, Carrilho, Flair J, Alves de Mattos, Angelo
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Antineoplastic Agents - adverse effects; Brazil; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Dermatologic adverse events; Drug Eruptions - diagnosis; Drug Eruptions - etiology; Drug Eruptions - mortality; Female; Gastroenterology and Hepatology; Hepatocellular carcinoma; Humans; Kaplan-Meier Estimate; Liver Neoplasms - drug therapy; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Male; Middle Aged; Neoplasm Staging; Niacinamide - adverse effects; Niacinamide - analogs & derivatives; Overall survival; Phenylurea Compounds - adverse effects; Proportional Hazards Models; Retrospective Studies; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 1665-2681
• DOI: 10.5604/16652681.1231587

AbstractBackground and Aims. The presence of dermatologic reaction as an adverse event to sorafenib treatment in patients with unre-sectable hepatocellular carcinoma has been indicated as a prognostic factor for survival in a recent prospective analysis. To date, this is the only clinical predictor of treatment response, which can be evaluated earlier in the treatment and, therefore, contribute to a better and more individualized patient management. Material and methods. This retrospective study included 127 patients treated with sorafenib under real-life practice conditions in two hepatology reference centers in Brazil. Demographic data, disease/medical history and time of sorafenib administration as well as adverse events related to the medication were recorded in a database. Results. Cirrhosis was present in 94% of patients, 85.6% were Child-Pugh A, 80.3%BCLC-C, 81% had vascular invasion and/or ext-rahepatic spread and 95% had a performance status 0 to 1.The median duration of treatment was 10.1 months (range: 0.1-47 months).The most common adverse event within the first 60 days of treatment were diarrhea (62.2%) and dermatological reaction (42%).The median overall survival for the cohort was 20 months, and it was higher for patients who developed dermatological reactions within the first 60 days compared to those who did not present this adverse event. Conclusion. This retrospective analysis showed the use of sorafenib in patients selected according to BCLC staging, and it is the first external validation of early dermatolog-ic adverse events as a predictor of overall survival in patients with advanced hepatocellular carcinoma.