Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Medical Affairs, Bayer Healthcare Pharmaceuticals, Seoul, Korea.
Cancer Res Treat. 2016 Oct;48(4):1243-1252. doi: 10.4143/crt.2015.278. Epub 2016 Feb 24.
The purpose of this study is to report real life experiences of sorafenib therapy for hepatocellular carcinoma (HCC) in Korea, using a subset of data from GIDEON (Global Investigation of Therapeutic Decisions in HCC and of Its Treatment with Sorafenib; a large, prospective, observational study).
Between January 2009 and April 2012, a total of 497 patients were enrolled from 11 sites in Korea. Of these, 482 patients were evaluable for safety analyses. Case report forms of paper or electronic version were used to record safety and efficacy data from all patients.
More patients of Child-Pugh A received sorafenib for > 8 weeks than did patients of Child-Pugh B (55.5% vs. 34.3%). Child-Pugh score did not appear to influence the starting dose of sorafenib, and approximately 70% of patients both in Child-Pugh A and B groups received the recommended initial daily dose of 800 mg (69.0% and 69.5%, respectively). The median overall survival (OS) and time to progression (TTP) were 8.5 months and 2.5 months. In Child-Pugh A patients, the median OS and TTP were 10.2 months and 2.5 months. The most frequent treatment-emergent drug-related adverse event was hand-foot skin reaction (31.7%), followed by diarrhea (18.0%). The incidence of treatment-emergent adverse events was similar in both Child-Pugh A (85.4%) and Child-Pugh B (84.8%) patients.
Sorafenib was well tolerated by Korean HCC patients in clinical settings, and the safety profile did not appear to differ by Child-Pugh status. Survival benefit in Korean patients was in line with that of a previous pivotal phase III trial (SHARP).
本研究旨在报告韩国索拉非尼治疗肝细胞癌(HCC)的真实临床经验,使用 GIDEON(全球 HCC 治疗决策及其索拉非尼治疗观察性研究;一项大型前瞻性观察研究)的数据子集。
2009 年 1 月至 2012 年 4 月,共从韩国的 11 个地点招募了 497 名患者。其中,482 名患者可进行安全性分析。使用纸质或电子版本的病例报告表记录所有患者的安全性和疗效数据。
更多的 Child-Pugh A 患者接受索拉非尼治疗 > 8 周,而非 Child-Pugh B 患者(55.5% vs. 34.3%)。Child-Pugh 评分似乎并不影响索拉非尼的起始剂量,约 70%的 A 组和 B 组患者均接受了推荐的初始每日 800mg 剂量(分别为 69.0%和 69.5%)。中位总生存期(OS)和无进展生存期(TTP)分别为 8.5 个月和 2.5 个月。在 Child-Pugh A 患者中,中位 OS 和 TTP 分别为 10.2 个月和 2.5 个月。最常见的治疗相关药物不良反应是手足皮肤反应(31.7%),其次是腹泻(18.0%)。Child-Pugh A(85.4%)和 Child-Pugh B(84.8%)患者的治疗相关不良事件发生率相似。
索拉非尼在韩国 HCC 患者的临床环境中具有良好的耐受性,安全性似乎与 Child-Pugh 状态无关。韩国患者的生存获益与之前的关键 III 期试验(SHARP)一致。