Kolamunnage-Dona, Ruwanthi, Berhane, Sarah, Potts, Harry, Williams, Edward H, Tanner, James, Janowitz, Tobias, Hoare, Matthew, Johnson, Philip (May 2021) Sorafenib is associated with a reduced rate of tumour growth and liver function deterioration in HCV-induced hepatocellular carcinoma. Journal of Hepatology. ISSN 0168-8278
Abstract
PURPOSE: Sorafenib has been the standard of care for patients with advanced hepatocellular carcinoma and although immunotherapeutic approaches are now challenging this position, it retains an advantage in HCV seropositive patients. We aimed to quantify the rate of tumour progression in patients receiving sorafenib and relate this figure to survival, both overall, and according to viral status. PATIENTS AND METHODS: Using serial data from an international clinical trial we applied a joint model to combine survival and progression over time so as to estimate the rate of tumour growth as assessed by tumour burden and serum AFP, and the impact of treatment on liver function. RESULTS: High tumour burden at baseline was associated with an increased risk of death. In patients still alive at the end of the study, the progression in relation to tumour burden was very low compared to those who died within the study. Overall, the change in mean tumour burden was 0.12 mm per day or an absolute growth rate of 3.6mm/month. Median doubling time (DT) was 665 days. For those who progressed above 0.12mm per day or 12% rate, median survival was 234 days compared to 384 days if the rate was below 12%. Tumour growth rate and serum AFP rise were significantly lower in those who were HCV seropositive as was the rate of decline in liver function. These results were replicated in two independent patient groups. CONCLUSION: Our analysis suggests that sorafenib treatment is associated with improved survival in patients with advanced hepatocellular carcinoma mainly by decreasing the rate of tumour growth and liver function deterioration among patients with HCV infection. LAY SUMMARY: Among patients receiving sorafenib for advanced hepatocellular carcinoma the rate of tumour growth (as assessed by changes in tumour size and the biomarker AFP) and the deterioration of liver function is less in those who have the Hepatitis C virus, than those who do not. CLINICAL TRIALS DATA: The clinical trials data belongs to Bristol Myers Squibb and AbbVie Inc. The clinical data belongs to Cambridge University Hospitals NHS Foundation Trust.
| Item Type: | Paper |
|---|---|
| Subjects: | diseases & disorders > cancer diseases & disorders diseases & disorders > neoplasms organs, tissues, organelles, cell types and functions > organs types and functions > liver diseases & disorders > cancer > cancer types > liver cancer diseases & disorders > cancer > cancer types |
| CSHL Authors: | |
| Communities: | CSHL labs > Janowitz lab CSHL Cancer Center Program CSHL Cancer Center Program > Cancer Genetics and Genomics Program |
| SWORD Depositor: | CSHL Elements |
| Depositing User: | CSHL Elements |
| Date: | 27 May 2021 |
| Date Deposited: | 02 Jun 2021 13:39 |
| Last Modified: | 13 Feb 2024 18:36 |
| PMCID: | PMC9158473 |
| URI: | https://repository.cshl.edu/id/eprint/40186 |
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