Field practice study of half‐dose sorafenib treatment on safety and efficacy for hepatocellular carcinoma: A propensity score analysis. Issue 3 (28th May 2014)

• Record Type: Journal Article
• Authors: Morimoto, Manabu; Numata, Kazushi; Kondo, Masaaki; Kobayashi, Satoshi; Ohkawa, Shinichi; Hidaka, Hisashi; Nakazawa, Takahide; Okuwaki, Yusuke; Okuse, Chiaki; Matsunaga, Kotaro; Suzuki, Michihiro; Morita, Satoshi; Taguri, Masataka; Tanaka, Katsuaki
• Is Part Of: Hepatology research. Volume 45:Issue 3(2015:Mar.)
• Page Start: 279
• Page End: 287
• Publication Date: 2014-05-28
• Subjects: Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.12354
• Languages: English
• ISSNs: 1386-6346

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="hepr12354-sec-0001" sec-type="section"> <title>Aim</title> <p>Patients with hepatocellular carcinoma (HCC) who receive an initial full dose of sorafenib (800 mg/day) often require a decreased dose (400 mg/day) or discontinuation of therapy because of severe adverse events. We conducted a retrospective analysis of patients with HCC to compare the safety and efficacy of full‐ to half‐dose sorafenib.</p> </sec> <sec id="hepr12354-sec-0002" sec-type="section"> <title>Methods</title> <p>We reviewed the medical records of 218 consecutive patients with intermediate or advanced stage HCC who received half (<italic>n</italic> = 73) or full‐dose sorafenib (<italic>n</italic> = 145) between 2009 and 2012 at four institutions. A propensity score‐matching analysis was used to adjust for potential bias.</p> </sec> <sec id="hepr12354-sec-0003" sec-type="section"> <title>Results</title> <p>Multivariate logistic regression analysis showed that increased age was an independent factor for the selection of initial half‐dose sorafenib (odds ratio, 1.10; 95% confidence interval, 1.05–1.15; <italic>P</italic> < 0.001). Fifty‐eight patients each in the half‐dose and full‐dose groups were selected for propensity score matching. The incidence of grade 3–4 severe adverse effects was lower in the half‐dose group (47.4% vs 66.7%, <italic>P</italic> = 0.037). In contrast, the median progression‐free survival (PFS) and overall survival (OS) rates were not significantly different (half‐dose group, 3.8 and 10.2 months; full‐dose group, 2.5 and 8.8 months; <italic>P</italic> = 0.143 and 0.911, respectively).</p> </sec> <sec id="hepr12354-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Propensity score‐matched analyses indicate that initial half‐dose sorafenib treatment led to fewer severe adverse effects and a comparable survival benefit compared with a full dose in select patients with HCC, particularly for those of advanced age.</p> </sec> </abstract>