Refining sorafenib therapy: Lessons from clinical practice

Luigi Bolondi, Antonio Craxi, Franco Trevisani, Bruno Daniele, Giovan Giuseppe Di Costanzo, Stefano Fagiuoli, Calogero Cammà, Paolo Bruzzi, Romano Danesi, Federico Spandonaro, Corrado Boni, Armando Santoro, Massimo Colombo

Research output: Contribution to journalArticle

Abstract

Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.

Original languageEnglish
Pages (from-to)449-465
Number of pages17
JournalFuture Oncology
Volume11
Issue number3
DOIs
Publication statusPublished - Feb 1 2015

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Keywords

  • adverse event management
  • Child-Pugh B
  • dose modification
  • elderly
  • hepatocellular carcinoma
  • mRECIST
  • postprogression treatment
  • real-world data
  • response assessment
  • sorafenib

ASJC Scopus subject areas

  • Oncology
  • Cancer Research
  • Medicine(all)

Cite this

Bolondi, L., Craxi, A., Trevisani, F., Daniele, B., Di Costanzo, G. G., Fagiuoli, S., Cammà, C., Bruzzi, P., Danesi, R., Spandonaro, F., Boni, C., Santoro, A., & Colombo, M. (2015). Refining sorafenib therapy: Lessons from clinical practice. Future Oncology, 11(3), 449-465. https://doi.org/10.2217/fon.14.261