Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma

Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease progression...

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Published in:Cancers 2019-08, Vol.11 (9), p.1256
Main Authors: Takada, Hitomi, Kurosaki, Masayuki, Tsuchiya, Kaoru, Komiyama, Yasuyuki, Itakura, Jun, Takahashi, Yuka, Nakanishi, Hiroyuki, Yasui, Yutaka, Tamaki, Nobuharu, Maeyashiki, Chiaki, Kaneko, Shun, Takaura, Kenta, Higuchi, Mayu, Okada, Mao, Wang, Wan, Osawa, Leona, Sekiguchi, Shuhei, Hayakawa, Yuka, Yamashita, Koji, Enomoto, Nobuyuki, Izumi, Namiki
Format: Article
Language:English
Subjects:
Albumin
Bilirubin
Candidates
Chemotherapy
Clinical trials
Hepatocellular carcinoma
Laboratories
Liver cancer
Liver diseases
Medical prognosis
Metastasis
Patients
Protein-tyrosine kinase
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Summary:Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease progression during sorafenib treatment. This is a retrospective cohort study of 190 consecutive HCC patients who were treated with sorafenib in our hospital. Three criteria of good candidates for second-line TKI at the time of disease progression during sorafenib treatment were defined as follows: criterion 1 was the same as the inclusion criteria of the regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE) study, criterion 2 was the inclusion criteria of the RESORCE study plus Child-Pugh score 5, and criterion 3 was the inclusion criteria of the RESORCE study plus albumin-bilirubin (ALBI) grade 1. Factors at baseline and at week 4 during sorafenib treatment were used to predict patients fulfilling each of these three criteria. The distribution of patients was 29%, 13%, and 6% in criteria 1, 2, and 3, respectively. Significant factors for meeting criterion 1 was the combination of baseline albumin >3.7 g/dL (odds ratio (OR) 2.7) plus degree of decrease in albumin (Δalbumin) at week 4
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers11091256