Addition of Y‑90 radioembolization increases tumor response and local disease control in hepatocellular carcinoma patients receiving sorafenib

cellular carcinoma (HCC) patients who received sorafenib treatment either alone or combined with radioembolization (RE). Methods: Follow-up images of the patients treated within a multicenter phase II trial (SORAMIC) were assessed by mRECIST. A total of 177 patients (73 combination arm [RE + sorafen...

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Autores: Öcal, O. (Osman)|||/items/e20f890d-387b-4b27-8cd2-bc265d1c07bb, Schütte, K. (Kerstin)|||/items/5b03b17f-f4d0-43da-942b-c4b939ec1d59, Zech, C.J. (Christoph J.)|||/items/d7e217ff-6d18-4103-a1d1-b11c7f91e05c, Loewe, C. (Christian)|||/items/164e0698-1ecb-4aa7-a49c-86c53c6b4686, Delden, O.M. (Otto M.) van|||/items/85600314-f061-4c21-8022-54570fcef98b, Vandecaveye, V. (Vincent)|||/items/228974b6-6c34-4de8-8832-52dec9dd333b, Verslype, C. (Chris)|||/items/b53da1b6-ea06-496d-8de8-e3e43a52ad2c, Gebauer, B. (Bernhard)|||/items/6cc5be89-3c27-45cd-8e43-cedfe44c9a88, Sengel, C. (Christian)|||/items/2a8ebe3b-7e9f-4924-ae83-b565dd6e87a2, Bargellini, I. (Irene)|||/items/2c302084-c5c3-4f12-8876-fc1da43d1c03, Iezzi, R. (Roberto)|||/items/91472f31-aae7-42fe-ac92-c228c63f762d, Philipp, A. (Alexander)|||/items/75e28337-ed92-4cfe-bcec-cca9feb66e21, Berg, T. (Thomas)|||/items/b24d8023-a52b-43bc-aae1-2eb6903e97a1, Klümpen, H. (Heinz)|||/items/6bb3d4b6-7e18-4aee-82af-296199525b09, Benckert, J. (Julia)|||/items/9863c66f-ac85-46f7-933d-ab278eb08bcb, Pech, M. (Maciej)|||/items/3952e467-7f56-4131-afac-c7864104471f, Gasbarrini, A. (Antonio)|||/items/abf16136-3e15-4dc4-898a-37218b06e35c, Amthauer, H. (Holger)|||/items/16b75dfd-ea71-4d83-9625-918129c0b3f8, Bartenstein, P. (Peter)|||/items/dad97af6-98b1-4425-8fde-ec9732a2aa6f, Sangro-Gómez-Acebo, B.C. (Bruno Carlos)|||/items/594bbdbb-046a-4ab2-878c-cb4fe577af49, Malfertheiner, P. (Peter)|||/items/7d7ba999-c5c6-4cf5-9cd3-1dffd4d4d26d, Ricke, J. (Jeans)|||/items/3bfc1d9c-b91e-4e2f-99ca-959622b33e38, Seidensticker, M. (Max)|||/items/5365aab8-55e0-458c-85f0-ff43e3b91270
Tipo de recurso: artículo
Fecha de publicación:2022
País:España
Institución:Consejo Superior de Investigaciones Científicas (CSIC)
Repositorio:Dadun. Depósito Académico Digital de la Universidad de Navarra
Idioma:inglés
OAI Identifier:oai:dadun.unav.edu:10171/118638
Acceso en línea:https://hdl.handle.net/10171/118638
Access Level:acceso abierto
Palabra clave:Hepatocellular carcinoma
Objective response
Radioembolization
Sorafenib
mRECIST
Descripción
Sumario:cellular carcinoma (HCC) patients who received sorafenib treatment either alone or combined with radioembolization (RE). Methods: Follow-up images of the patients treated within a multicenter phase II trial (SORAMIC) were assessed by mRECIST. A total of 177 patients (73 combination arm [RE + sorafenib] and 104 sorafenib arm) were included in this post-hoc analysis. Response and progression characteristics were compared between treatment arms. Survival analyses were done to compare PFS and post-progression survival between treatment arms. Multivariate Cox regression analysis was used to compare survival with factors known to influence PFS in patients with HCC. Results: The combination arm had significantly higher objective response rate (61.6% vs. 29.8%, p < 0.001), complete response rate (13.7% vs. 3.8%, p = 0.022), and a trend for higher disease control rate (79.2% vs. 72.1%, p = 0.075). Progression was encountered in 116 (65.5%) patients and was more common in the sorafenib arm (75% vs. 52.0%, p = 0.001). PFS (median 8.9 vs. 5.4 months, p = 0.022) and hepatic PFS were significantly better in the combination arm (9.0 vs. 5.7 months, p = 0.014). Multivariate analysis confirmed the treatment arm as an independent predictor of PFS. Conclusion: In advanced HCC patients receiving sorafenib, combination with RE has an additive anticancer effect on sorafenib treatment resulting in a higher and longer tumor response. However, the enhanced response did not translate into prolonged survival. Better patient selection and superselective treatment could improve outcomes after combination therapy.

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