Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosisand low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factorreceptor beta (PDGFR-β) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenibto life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy andside effects of sorafenib therapy in Turkey. Materials and
Methods: Data for 103 patients (82 males, 21 females)receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median agewas 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of thepatients had Child scores meeting the utilization permit of the drug in our country (Child A).
Results: A totalof 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluablecases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%).Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reducedonly in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-footsyndrome, 7 (7%) diarrhea, and 2 (2%) vomiting.
Conclusions: This retrospective study demonstrated betterefficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-freesurvival and overall survival findings were comparable. The side effect rates indicate that the drug was toleratedwell. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patientswith inoperable or metastatic HCC.