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First‐line sorafenib sequential therapy and liver disease etiology for unresectable hepatocellular carcinoma using inverse probability weighting: A multicenter retrospective study

First‐line sorafenib sequential therapy and liver disease etiology for unresectable hepatocellular carcinoma using inverse probability weighting: A multicenter retrospective study

Authors :
Masahiko Kajiwara
Hironori Koga
Takumi Kawaguchi
Taizo Yamaguchi
Hideya Suga
Yu Noda
Shusuke Okamura
Masatoshi Tanaka
Atsushi Hiraoka
Takaaki Tanaka
Takuji Torimura
Tomotake Shirono
Naoki Kamachi
Hiroshi Kawano
Masahito Nakano
Takashi Niizeki
Satoshi Itano
Shigeo Shimose
Kazunori Noguchi
Yoshinori Yokokura
Hajime Aino
Kei Ogata
Hideki Iwamoto
Norito Matsukuma
Source :
Cancer Medicine, Vol 10, Iss 23, Pp 8530-8541 (2021), Cancer Medicine
Publication Year :
2021
Publisher :
Wiley, 2021.

Abstract

Background and Aims Sequential therapy with molecular‐targeted agents (MTAs) is considered effective for unresectable hepatocellular carcinoma (HCC) patients. This study purposed to evaluate the efficacy of sequential therapy with sorafenib (SORA) as a first‐line therapy and to investigate the therapeutic impact of SORA in nonalcoholic fatty liver disease (NAFLD) or nonalcoholic steato hepatitis (NASH)‐related HCC. Methods We evaluated 504 HCC patients treated with SORA (Study‐1). The times of administration for sorafenib from 2009 to 2015, 2016 to 2017, and 2018 and later were defined as the early‐, mid‐, and late‐term periods, respectively. Among them, 180 HCC patients treated with SORA in addition to MTAs in the mid‐ and late‐term periods were divided into groups based on disease etiology (NAFLD or NASH [n = 37] and viral or alcohol [n = 143]), and outcomes were compared after inverse probability weighting (IPW) (Study‐2). Results Overall survival (OS) of HCC patients who received sequential MTA therapy after first‐line SORA was significantly longer. The median survival times (MST) were 12.6 versus 17.6 versus 17.4 months in the early‐term group, mid‐term group, and the later‐time group (early vs. mid, p = 0.014, early vs. later. p = 0.045), respectively. (Study‐1). In Study‐2, there was no significant differences in OS between the Virus/alcohol group and the NAFLD/NASH group in patients who received sequential therapy (MST was 23.4 and 27.0 months p = 0.173, respectively). The NAFLD or NASH, female sex, albumin‐bilirubin (ALBI) grade 2b, and major Vp (Vp3/Vp4) were significant factors for OS treated with SORA. Conclusions Sequential therapy with SORA as the first‐line treatment improved the prognosis of unresectable HCC patients and was effective regardless of HCC etiology.<br />Sequential therapy with SORA as the first‐line treatment prolonged the prognosis of unresectable HCC patients and was effective regardless of HCC etiology.

Details

ISSN :
20457634
Volume :
10
Database :
OpenAIRE
Journal :
Cancer Medicine
Accession number :
edsair.doi.dedup.....69fca81c2c710227e89f771d0cd26df5
Full Text :
https://doi.org/10.1002/cam4.4367