Table of Contents Author Guidelines Submit a Manuscript
The Scientific World Journal
Volume 2013, Article ID 931972, 6 pages
http://dx.doi.org/10.1155/2013/931972
Clinical Study

Sorafenib in Advanced Hepatocellular Carcinoma: A Nationwide Retrospective Study of Efficacy and Tolerability

1Department of Oncology, Aarhus University Hospital, Norrebrogade 44, 8000 Aarhus, Denmark
2Department of Oncology, Rigshospitalet, 2100 Copenhagen, Denmark
3Department of Hepatology and Gastroenterology, Aarhus University Hospital, 8000 Aarhus, Denmark

Received 5 December 2012; Accepted 30 December 2012

Academic Editors: K. Aoyagi, A. Beltsis, and T. K. Ti

Copyright © 2013 Anne Helene Køstner et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Advanced HCC is a clinical challenge with limited treatment options. The multikinase inhibitor sorafenib is the first and only agent showing a survival benefit in these patients. In this study we evaluate the efficacy and tolerability of sorafenib in an unselected patient population. Furthermore we explore the role of alpha-fetoprotein (αFP) as a potential biomarker for treatment efficacy and correlation to survival. Methods. Seventy-six patients with advanced HCC, not eligible for locoregional therapy, treated with sorafenib between 2007 and 2009 were included. Followup was until 2011. Results. Patients in PS 0-1 had a median overall survival (mOS) of 6.2 months, compared to 1.8 months in patients with poorer PS ( ). Child-Pugh A patients had a mOS of 6.6 months versus 3.6 months among patients in Child-Pugh B or C ( ). Serum αFP ≥ 200 at baseline was prognostic for a shorter survival. All patients with radiologically verified tumor response and baseline αFP ≥ 200 experienced a significant decline in αFP within the first four weeks of treatment. Conclusion. The survival of patients with advanced HCC treated with sorafenib is dependent on performance status and liver function. Treatment of patients with compromised liver function and poor performance status cannot be recommended. The correlation between αFP and objective tumor response warrants further investigation.