Combination of sorafenib and transarterial chemoembolization in selected patients with advanced-stage hepatocellular carcinoma: a retrospective cohort study at three german liver centers

  • Background and Aims. Systemic treatment with sorafenib has been the standard of care (SOC) in patients with advanced Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) for more than a decade. TACE has been reported to allow better local tumor control in selected patients with BCLC stage C HCC. Methods. A retrospective analysis of patients with BCLC stage C HCC that were treated with sorafenib and TACE was conducted; they were compared to BCLC stage C patients treated either with TACE or sorafenib in the same period of time outside a clinical trial. Results. A total of 201 patients with BCLC stage C were identified, who were treated with either sorafenib and TACE (group A; n = 54), sorafenib (group B; n = 82) or TACE (group C; n = 65). No significant difference in baseline characteristics was observed. Time to progression was 7.0 months (95% CI: 4.3–9.7), 4.1 months (95% CI: 3.6–4.7) and 5.0 months (95% CI: 2.9–7.1) in groups A, B and C, respectively, and overall survival was 16.5 months (95% CI: 15.0–18.1), 8.4 months (95% CI: 6.0–10.8) and 10.5 months (95% CI: 7.5–13.6), respectively (group A vs. group B: p < 0.001; group A vs. group C: p = 0.0023). Adverse events of grade 3/4 occurred in 34% of patients in group A. Conclusions. Although sorafenib is a SOC in patients with BCLC stage C HCC, TACE is frequently used as an additional locoregional treatment in selected patients. This combined approach resulted in a significant overall survival benefit in selected patients, although randomized trials have not yet proven this benefit.

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Author:Christine KochORCiD, Markus Göller, Eckart SchottGND, Oliver WaidmannORCiDGND, Mark op den Winkel, Philipp Marius Paprottka, Stephan ZangosGND, Thomas Vogel, Wolf Otto BechsteinORCiDGND, Stefan ZeuzemORCiDGND, Frank Thomas Kolligs, Jörg TrojanORCiDGND
Parent Title (English):Cancers
Place of publication:Basel
Document Type:Article
Date of Publication (online):2021/04/28
Date of first Publication:2021/04/28
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2021/09/06
Tag:HCC; TACE; sorafenib; treatment
Issue:9, art. 2121
Page Number:11
First Page:1
Last Page:11
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 4.0