Safety and efficacy of sorafenib in patients with hepatocellular carcinoma (HCC) and Child-Pugh A versus B cirrhosis

Ghassan K. Abou-Alfa, Dino Amadori, Armando Santoro, Arie Figer, Jacques de Greve, Chetan Lathia, Dimitris Voliotis, Sibyl Anderson, Marius Moscovici, Sergio Ricci

Research output: Contribution to journalArticle

Abstract

Background: We performed a retrospective analysis of data from a phase II study evaluating sorafenib in patients with advanced hepatocellular carcinoma (HCC) to assess differences in safety and efficacy based on Child-Pugh (CP) status (A/B). Methods: Patients received sorafenib 400 mg PO bid. We analyzed safety, pharmacokinetic (PK), and efficacy data in the two CP groups. Results: Ninety-eight patients were CP A; 38 were CP B, with a median duration of therapy of 4 and 1.8 months, respectively. Grade 3/4 adverse events in the CP A and B groups, respectively, included hyperbilirubinemia (14% and 53%), ascites (3% and 5%), and encephalopathy (3% and 13%). Median overall survival (OS) in the CP A group was 9.5 months, compared with 3.2 months in the CP B population. Responses were limited in both groups. AUC and Cmax values were comparable between the two groups. Conclusions: Due to the lack of randomization against placebo or no therapy in this study, it is unclear if the more frequent worsening of liver cirrhosis and outcome of CP B patients are drug related or due to disease progression, or both. As expected, outcome was poorer in patients with CP B than in those with CP A cirrhosis. The hyperbilirubinemia seen in both groups may be at least partly related to inhibition of UGT1A1 by sorafenib. PK profiles were similar in the two groups. More data are needed to confirm and more fully understand the safety and efficacy of sorafenib in patients with advanced HCC and CP B cirrhosis.

Original languageEnglish
Pages (from-to)40-44
Number of pages5
JournalGastrointestinal Cancer Research
Volume4
Issue number2
Publication statusPublished - Mar 2011

ASJC Scopus subject areas

  • Oncology
  • Gastroenterology

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    Abou-Alfa, G. K., Amadori, D., Santoro, A., Figer, A., de Greve, J., Lathia, C., Voliotis, D., Anderson, S., Moscovici, M., & Ricci, S. (2011). Safety and efficacy of sorafenib in patients with hepatocellular carcinoma (HCC) and Child-Pugh A versus B cirrhosis. Gastrointestinal Cancer Research, 4(2), 40-44.