Sorafenib for patients with advanced hepatocellular carcinoma and the impact to alpha fetoprotein var iation

TANG Daping; LIN Rujing; WANG Xuejian

doi:10.3969/j.issn.1671-6450.2014.05.004

Abstract：Objective To investigate therapeutic effect of sorafenib for advanced hepatocelluar carcinoma ( HCC ) , including progression free survival (PFS), overall survival (OS) and alpha fetoprotein(AFP) variation to identify the prog-nostic usefulness of AFP response in clinic application .Methods Pathologically confirmed or clinically diagnosed patients with advanced HCC in 61 cases, continuous oral sorafenib efficacy evaluation based on Response Evaluation Criteria in Solid Tumors (RECIST), and in the first six weeks, detected serum AFP level and did imaging examination , using the Cox propor-tional hazards model to detect patients with HCC risk ratio .Results 61 patients with median PFS was 7 months (95% CI 2.1-14.3 months), and median OS was 11 months (95% CI 7.2-23.6 months).RECIST assessment, CR in 2 cases (3.3%), PR in 6 cases (9.8%), SD in 37 cases (60.7%), PD in 16 cases (26.2%);disease control rate was 73.8%. AFP responders and non-responders PFS with OS difference was statistically significant ( P <0.05);while the control group and radiographic imaging of tumor progression and OS ,PFS group differences were not statistically significant ( P >0.05) AFP response group risk ratio of PFS and OS was 0.58 (95%CI 0.26-0.97) and 0.68 (95%CI 0.31-0.89), while the risk of radiological controls PFS with OS ratios were 0.96 (95%CI 0.35-1.57) and 0.98 (95%CI 0.71-2.46).In mul-tivariate Cox regression analysis , CLIP score and AFP responses of these two factors was significant .Taking sorafenib main ad-verse reactions were hand-foot skin reaction and white blood cells , thrombocytopenia , after symptomatic treatment or reduce the dose can be significantly alleviated .Conclusion The sorafenib was efficient in the treatment of advanced HCC .AFP re-sponse may be considered as a novel method to capture sorafenib activity in advanced HCC .