Comparison of Sorafenib versus Hepatic Arterial Infusion Chemotherapy-Based Treatment for Advanced Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Sorafenib is the first approved systemic treatment for advanced hepatocellular carcinoma (HCC). However, its clinical utility is limited, especially in Asian countries. Several reports have suggested the survival benefits of hepatic arterial infusion chemotherapy (HAIC) for advanced HCC with main po...

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Published in:Gut and liver Vol. 15; no. 2; pp. 284 - 294
Main Authors: Ahn, Young Eun, Suh, Sang Jun, Yim, Hyung Joon, Seo, Yeon Seok, Yoon, Eileen L., Kim, Tae Hyung, Lee, Young Sun, Yim, Sun Young, Kim, Hae Rim, Kang, Seong Hee, Jung, Young Kul, Kim, Ji Hoon, Yeon, Jong Eun, Um, Soon Ho, Byun, Kwan Soo
Format: Journal Article
Language:English
Published: Korea (South) Editorial Office of Gut and Liver 15.03.2021
Gastroenterology Council for Gut and Liver
거트앤리버 소화기연관학회협의회
Subjects:
Antineoplastic Combined Chemotherapy Protocols
carcinoma
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - drug therapy
chemotherapy
hepatic artery
hepatocellular
Humans
Liver Neoplasms - complications
Liver Neoplasms - drug therapy
Original
Portal Vein
portal vein thrombosis
sorafenib
Sorafenib - therapeutic use
Thrombosis
Treatment Outcome
내과학
Hepatic artery
Chemotherapy
Carcinoma
Sorafenib
Portal vein thrombosis
hepatocellular
ISSN:1976-2283, 2005-1212, 2005-1212
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Summary:Sorafenib is the first approved systemic treatment for advanced hepatocellular carcinoma (HCC). However, its clinical utility is limited, especially in Asian countries. Several reports have suggested the survival benefits of hepatic arterial infusion chemotherapy (HAIC) for advanced HCC with main portal vein tumor thrombosis (PVTT). This study aimed to compare the efficacy of sorafenib-based therapy with that of HAIC-based therapy for advanced HCC with main PVTT. Advanced HCC patients with main PVTT treated with sorafenib or HAIC between 2008 and 2016 at Korea University Medical Center were included. We evaluated overall survival (OS), time-to-progression (TTP), and the disease control rate (DCR). Seventy-three patients were treated with sorafenib (n=35) or HAIC (n=38). Baseline characteristics were not significantly different between groups, except the presence of solid organ metastasis (46% vs 5.3%, p<0.001). The median OS time was not significantly different between the groups (6.4 months vs 10.0 months, p=0.139). TTP was longer in the HAIC group than in the sorafenib group (2.1 months vs 6.2 months, p=0.006). The DCR was also better in the HAIC group than in the sorafenib group (37% vs 76%, p=0.001). Subgroup analysis, which excluded patients with extrahepatic solid organ metastasis, showed the same trends for the median OS time (8.8 months vs 11.1 months, p=0.097), TTP (1.9 months vs 6.0 months, p<0.001), and DCR (53% vs 81%, p=0.030). HAIC-based therapy may be an alternative to sorafenib for advanced HCC with main PVTT by providing longer TTP and a better DCR.
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Young Eun Ahn and Sang Jun Suh contributed equally to this work as first authors.
ISSN:1976-2283
2005-1212
2005-1212
DOI:10.5009/gnl19367