Identification of clinical biomarkers for patients with advanced hepatocellular carcinoma receiving sorafenib.
BACKGROUND
Identification of patients with advanced HCC-deriving preferential benefit from sorafenib is desirable, and treatment-related adverse events are potential clinical biomarkers.


METHODS
Survival and toxicity data for patients with HCC treated with sorafenib at the Christie NHS Foundation Trust from 11/09 to 02/15 were collected retrospectively.


RESULTS
Eighty-five eligible patients were identified. The most common grade 3 or 4 treatment-related toxicities were hypertension (HTN, 45 %), fatigue (8 %), and hand-foot syndrome (HFS, 8 %). Any-grade HFS and/or worsening HTN (HFS/HTN) were experienced by 58 % of patients. Estimated median progression-free and overall survival (OS) were 4.6 (95 % CI 2.8-5.2) and 6.5 (95 % CI 4.9-8.01) months, respectively. Child-Pugh score (p value <0.001) and the development of HFS/HTN were independent prognostic factors impacting on OS on multivariable analysis. Patients who developed HFS/HTN had median OS of 8.2 months (95 % CI 6.5-12.4) compared with 4.1 (95 % CI 2.7-5.4) for those without this toxicity (Hazard Ratio (HR) 0.4, 95 % CI 0.2-0.7, p value 0.003). The prognostic impact of HFS/HTN was confirmed by landmark analyses limited to patients who lived a minimum of 2 months (p value 0.019) or who developed HFS/HTN in the first 3 months of treatment (p value 0.006).


CONCLUSION(S)
The development of toxicities specific to sorafenib is associated with prolonged survival in a UK-based HCC patient series; prospective assessment of their significance is required.
['Lamarca|A|A|', 'Abdel-Rahman|O|O|', 'Salu|I|I|', 'McNamara|M G|MG|', 'Valle|J W|JW|', 'Hubner|R A|RA|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D000970:Antineoplastic Agents D014408:Biomarkers, Tumor D006528:Carcinoma, Hepatocellular D005260:Female D005500:Follow-Up Studies D006801:Humans D008113:Liver Neoplasms D008297:Male D008875:Middle Aged D009367:Neoplasm Staging D009536:Niacinamide D010671:Phenylurea Compounds D011379:Prognosis D012189:Retrospective Studies D000077157:Sorafenib D015996:Survival Rate
Clinical Biomarker Sorafenib Survival Toxicity Hepatocellular carcinoma (HCC)