索拉非尼治疗晚期肝细胞癌：高血压可能成为疗效的替代标志物。

Sorafenib in advanced hepatocellular carcinoma: hypertension as a potential surrogate marker for efficacy.

机构信息

Medical Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.

出版信息

Am J Clin Oncol. 2013 Aug;36(4):319-24. doi: 10.1097/COC.0b013e3182468039.

DOI:10.1097/COC.0b013e3182468039

PMID:22547010

Abstract

BACKGROUND

Advanced hepatocellular cancer (HCC) is an incurable disease with limited options for systemic treatment. Sorafenib was approved for advanced HCC based on trials in patients with Child-Pugh class A. We reviewed our experience retrospectively in patients with HCC who were treated with sorafenib with a focus on Child-Pugh B (CP-B) liver cirrhosis and effect of hypertension (HTN) on survival.

METHODS

We retrospectively reviewed medical charts of patients with documented advanced HCC who received sorafenib since 2007. Survival data were plotted according to Child-Pugh class and HTN.

RESULTS

Results of 41 patients 39% had CP-B. Eighty-five percent were male and 67% had HCC due to viral hepatitis. Fifty-six percent received localized treatment before sorafenib. Five percent had a partial response and 39% had stable disease. Time to progression and overall survival (OS) for all patients were 3.2 and 6.2 months, respectively. Time to progression and OS were 4 and 8.4 months in Child-Pugh class A patients and 2 and 3.2 months in CP-B patients, which were statistically significant. Patients who had documented HTN while on treatment according to Common Terminology Criteria for Adverse Events version 3.0 had significantly better OS (18.2 vs. 4.5 mo; P=0.016).

CONCLUSIONS

Development of HTN with sorafenib seems to be associated with a favorable effect on prognosis. Future trials should examine this observation.

摘要

背景

晚期肝细胞癌（HCC）是一种无法治愈的疾病，其全身治疗选择有限。索拉非尼是基于 A 级 Child-Pugh 试验批准用于晚期 HCC 的。我们回顾性地回顾了我们用索拉非尼治疗 HCC 患者的经验，重点关注 B 级 Child-Pugh（CP-B）肝硬化和高血压（HTN）对生存的影响。

方法

我们回顾性地审查了自 2007 年以来接受过索拉非尼治疗的有记录的晚期 HCC 患者的病历。根据 Child-Pugh 分级和 HTN 绘制生存数据。

结果

41 例患者中有 39%为 CP-B。85%为男性，67%的 HCC 由病毒性肝炎引起。56%的患者在接受索拉非尼治疗前接受了局部治疗。5%的患者有部分缓解，39%的患者有稳定的疾病。所有患者的无进展生存期和总生存期（OS）分别为 3.2 和 6.2 个月。Child-Pugh 分级 A 患者的无进展生存期和 OS 分别为 4 和 8.4 个月，CP-B 患者为 2 和 3.2 个月，差异有统计学意义。根据不良事件通用术语标准 3.0 版，治疗期间有记录的 HTN 的患者 OS 明显更好（18.2 与 4.5 个月；P=0.016）。