Medical Oncology Unit, San Giovanni di Dio Hospital, Via Giovanni XXII, 80020, Frattaminore, Naples, Italy.
Cancer Chemother Pharmacol. 2010 Oct;66(5):837-44. doi: 10.1007/s00280-009-1226-z. Epub 2009 Dec 30.
Advanced hepatocellular carcinoma (HCC) not eligible for local therapies has limited chances of cure. Sorafenib is a multikinase inhibitor with proven activity in advanced HCC. Octreotide is used in this setting with conflicting results. Treatment with sorafenib and long-acting octreotide was tested in advanced HCC to evaluate safety and activity.
Fifty patients with advanced HCC, Child-Pugh A or B, received sorafenib at a dosage of 800 mg/day for 28 days with a following week of rest and long-acting octreotide at a dose of 40 mg, administered every 28 days.
All patients were assessable for safety and efficacy. Sixteen patients out of 50 (34%) were naïve from other therapies, while all the others were previously treated with local and/or systemic treatments. We achieved 5 partial responses (10%), 33 stable diseases (66%) and 12 progressions of disease (24%). Median time to progression was 7.0 months (95% CI, 3.0-10.9 months), and median overall survival was 12 months (95% CI, 6.3-17.4 months). Treatment was well tolerated. Diarrhoea (6%) and hypertension (4%) were the most frequent grade 3 toxicities.
Our data suggest that the combination between sorafenib and long-acting octreotide is active and well tolerated in patients with advanced HCC and could represent another efficacious chance for the management of this population.
不适合局部治疗的晚期肝细胞癌(HCC)治愈机会有限。索拉非尼是一种多激酶抑制剂,已被证明对晚期 HCC 有效。奥曲肽在这种情况下使用,但结果存在争议。在晚期 HCC 中测试了索拉非尼和长效奥曲肽的联合治疗,以评估其安全性和疗效。
50 例 Child-Pugh A 或 B 的晚期 HCC 患者接受索拉非尼治疗,剂量为 800mg/天,连用 28 天,随后休息一周,再给予长效奥曲肽,剂量为 40mg,每 28 天给药一次。
所有患者均可进行安全性和疗效评估。50 例患者中有 16 例(34%)为其他治疗方法初治患者,而其余所有患者均为局部和/或全身治疗的既往治疗患者。我们获得了 5 例部分缓解(10%)、33 例稳定疾病(66%)和 12 例疾病进展(24%)。中位无进展生存期为 7.0 个月(95%CI,3.0-10.9 个月),中位总生存期为 12 个月(95%CI,6.3-17.4 个月)。治疗耐受性良好。腹泻(6%)和高血压(4%)是最常见的 3 级毒性。
我们的数据表明,索拉非尼和长效奥曲肽联合治疗在晚期 HCC 患者中具有活性且耐受性良好,可能为该人群的治疗提供另一种有效的选择。