Field practice study of half-dose sorafenib treatment on safety and efficacy for hepatocellular carcinoma: A propensity score analysis.
AIM
Patients with hepatocellular carcinoma (HCC) who receive an initial full dose of sorafenib (800 mg/day) often require a decreased dose (400 mg/day) or discontinuation of therapy because of severe adverse events. We conducted a retrospective analysis of patients with HCC to compare the safety and efficacy of full- to half-dose sorafenib.


METHODS
We reviewed the medical records of 218 consecutive patients with intermediate or advanced stage HCC who received half (n = 73) or full-dose sorafenib (n = 145) between 2009 and 2012 at four institutions. A propensity score-matching analysis was used to adjust for potential bias.


RESULTS
Multivariate logistic regression analysis showed that increased age was an independent factor for the selection of initial half-dose sorafenib (odds ratio, 1.10; 95% confidence interval, 1.05-1.15; P < 0.001). Fifty-eight patients each in the half-dose and full-dose groups were selected for propensity score matching. The incidence of grade 3-4 severe adverse effects was lower in the half-dose group (47.4% vs 66.7%, P = 0.037). In contrast, the median progression-free survival (PFS) and overall survival (OS) rates were not significantly different (half-dose group, 3.8 and 10.2 months; full-dose group, 2.5 and 8.8 months; P = 0.143 and 0.911, respectively).


CONCLUSION
Propensity score-matched analyses indicate that initial half-dose sorafenib treatment led to fewer severe adverse effects and a comparable survival benefit compared with a full dose in select patients with HCC, particularly for those of advanced age.
['Morimoto|Manabu|M|', 'Numata|Kazushi|K|', 'Kondo|Masaaki|M|', 'Kobayashi|Satoshi|S|', 'Ohkawa|Shinichi|S|', 'Hidaka|Hisashi|H|', 'Nakazawa|Takahide|T|', 'Okuwaki|Yusuke|Y|', 'Okuse|Chiaki|C|', 'Matsunaga|Kotaro|K|', 'Suzuki|Michihiro|M|', 'Morita|Satoshi|S|', 'Taguri|Masataka|M|', 'Tanaka|Katsuaki|K|']
sorafenib hepatocellular carcinoma propensity score dose age adverse drug reaction