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真实世界、观察性、回顾性研究,评估索拉非尼治疗晚期肝细胞癌患者的疗效和安全性。

Real-World, Observational, Retrospective Study to Evaluate the Effectiveness and Safety of Treatment with Sorafenib in Patients with Advanced Hepatocellular Carcinoma.

机构信息

Oncology, Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo 01246-000, Brazil.

Comprehensive Center for Precision Oncology C2PO, Center for Translational Research in Oncology, Instituto do Cancer do Estado de Sao Paulo, Faculdade de Medicina da Universidade de Sao Paulo, São Paulo 01246-000, Brazil.

出版信息

Curr Oncol. 2024 Nov 1;31(11):6778-6790. doi: 10.3390/curroncol31110500.

Abstract

BACKGROUND

Hepatocellular carcinoma (HCC) accounts for approximately 90% of liver cancer cases. Sorafenib, the first drug to demonstrate survival benefits for advanced HCC, was validated through the SHARP randomized clinical trial (RCT). While RCTs are essential for assessing new therapies, real-world studies provide additional insights into their effectiveness in routine clinical practice. This study aimed to evaluate sorafenib's real-world effectiveness by analyzing overall survival (OS) and the time to radiological and symptomatic progression.

METHODS

Data from 368 patients treated with sorafenib at a Brazilian Cancer Center between 2009 and 2020 were retrospectively reviewed.

RESULTS

The median OS was 9.6 months, and the time to radiological progression was 5.3 months, similar to the SHARP trial. However, the time to symptomatic progression was shorter (2.3 months) than the SHARP study (4.1 months). In terms of safety, 27.4% of patients presented clinically relevant toxicities, and 24.5% needed to discontinue treatment due to toxicity.

CONCLUSIONS

Overall, sorafenib demonstrated effectiveness in the studied population, with OS and radiological progression times comparable to SHARP study results. The difference in symptomatic progression may be due to the study's retrospective nature and limitations.

摘要

背景

肝细胞癌(HCC)约占肝癌病例的 90%。索拉非尼是首个证明对晚期 HCC 具有生存获益的药物,其疗效已通过 SHARP 随机临床试验(RCT)得到验证。虽然 RCT 对于评估新疗法至关重要,但真实世界研究为其在常规临床实践中的疗效提供了更多的见解。本研究旨在通过分析总生存期(OS)和影像学及症状进展时间,评估索拉非尼在真实世界中的疗效。

方法

回顾性分析了 2009 年至 2020 年在巴西癌症中心接受索拉非尼治疗的 368 例患者的数据。

结果

中位 OS 为 9.6 个月,影像学进展时间为 5.3 个月,与 SHARP 试验相似。然而,症状进展时间更短(2.3 个月),短于 SHARP 研究(4.1 个月)。在安全性方面,27.4%的患者出现具有临床意义的毒性,24.5%的患者因毒性而需要停止治疗。

结论

总体而言,索拉非尼在研究人群中表现出疗效,OS 和影像学进展时间与 SHARP 研究结果相当。症状进展的差异可能归因于研究的回顾性和局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6968/11592708/5af5db569dbf/curroncol-31-00500-g001.jpg

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