Department of Gastroenterology and Hepatology, Medical University of Vienna, Vienna, Austria.
Eur J Gastroenterol Hepatol. 2010 Apr;22(4):391-8. doi: 10.1097/MEG.0b013e328333df23.
An expert panel was convened to reach a consensus on the current use of sorafenib in the treatment of hepatocellular carcinoma (HCC). A multinational, multidisciplinary group of experts objectively reviewed clinical data of sorafenib and considered clinical experience to develop statements summarizing our consensus on the current use of sorafenib. Sorafenib is the standard of care for Child-Pugh (CP) A patients with advanced HCC (i.e. not amenable to surgery or locoregional treatment). There is currently insufficient evidence to support the routine clinical use of sorafenib in CP B patients, but sorafenib can be offered as an option for those with compensated liver cirrhosis. Patients with stable performance status who have progressive disease during sorafenib treatment can be maintained on sorafenib, although there are no clear data supporting the continuation of sorafenib in these patients. The effectiveness of the adjuvant use of sorafenib in preventing recurrence after resection or local ablation, or in combination with transarterial chemoembolization, are being evaluated in clinical studies. In conclusion, sorafenib has extended treatment options for patients with HCC, and is now established as the standard of care for CP A patients with HCC not amenable to surgery or locoregional treatment. Based on its multikinase-inhibitor activity and proven efficacy in prolonging survival in HCC, broader use - including a subgroup of patients with CP B (clinically compensated cirrhosis) and earlier disease stages - might be expected dependent on the results of ongoing studies of safety and clinically relevant benefit in these patients.
一个专家小组被召集来就索拉非尼在肝细胞癌（HCC）治疗中的当前应用达成共识。一个多国家、多学科的专家小组客观地审查了索拉非尼的临床数据，并考虑了临床经验，以制定总结我们对索拉非尼当前应用的共识的声明。索拉非尼是 Child-Pugh（CP）A级晚期 HCC（即不适宜手术或局部治疗）患者的标准治疗方法。目前没有足够的证据支持 CP B 级患者常规临床使用索拉非尼，但可以将其作为代偿性肝硬化患者的选择。对于稳定的体能状态且在索拉非尼治疗期间疾病进展的患者，可以继续使用索拉非尼，尽管没有明确的数据支持这些患者继续使用索拉非尼。索拉非尼在预防切除或局部消融后复发或与经动脉化疗栓塞联合应用的辅助治疗效果正在临床试验中进行评估。总之，索拉非尼为 HCC 患者提供了更多的治疗选择，现已成为不能手术或局部治疗的 CP A 级 HCC 患者的标准治疗方法。基于其多激酶抑制剂活性和在延长 HCC 患者生存方面的已证实疗效，在这些患者中进行的安全性和临床相关获益的研究结果，如果结果安全且具有临床相关获益，可能会扩大其使用范围，包括 CP B 级（临床代偿性肝硬化）患者亚组和更早的疾病阶段。
