Koch, Christine;
Göller, Markus;
Schott, Eckart;
Waidmann, Oliver;
op den Winkel, Mark;
Paprottka, Philipp;
Zangos, Stephan;
Vogl, Thomas;
Bechstein, Wolf Otto;
Zeuzem, Stefan;
Kolligs, Frank T.;
Trojan, Jörg
Combination of Sorafenib and Transarterial Chemoembolization in Selected Patients with Advanced-Stage Hepatocellular Carcinoma: A Retrospective Cohort Study at Three German Liver Centers
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Media type:
E-Article
Title:
Combination of Sorafenib and Transarterial Chemoembolization in Selected Patients with Advanced-Stage Hepatocellular Carcinoma: A Retrospective Cohort Study at Three German Liver Centers
Contributor:
Koch, Christine;
Göller, Markus;
Schott, Eckart;
Waidmann, Oliver;
op den Winkel, Mark;
Paprottka, Philipp;
Zangos, Stephan;
Vogl, Thomas;
Bechstein, Wolf Otto;
Zeuzem, Stefan;
Kolligs, Frank T.;
Trojan, Jörg
Published:
MDPI AG, 2021
Published in:
Cancers, 13 (2021) 9, Seite 2121
Language:
English
DOI:
10.3390/cancers13092121
ISSN:
2072-6694
Origination:
Footnote:
Description:
Background and Aims. Systemic treatment with sorafenib has been the standard of care (SOC) in patients with advanced Barcelona Clinic Liver Cancer (BCLC) stage C hepatocellular carcinoma (HCC) for more than a decade. TACE has been reported to allow better local tumor control in selected patients with BCLC stage C HCC. Methods. A retrospective analysis of patients with BCLC stage C HCC that were treated with sorafenib and TACE was conducted; they were compared to BCLC stage C patients treated either with TACE or sorafenib in the same period of time outside a clinical trial. Results. A total of 201 patients with BCLC stage C were identified, who were treated with either sorafenib and TACE (group A; n = 54), sorafenib (group B; n = 82) or TACE (group C; n = 65). No significant difference in baseline characteristics was observed. Time to progression was 7.0 months (95% CI: 4.3–9.7), 4.1 months (95% CI: 3.6–4.7) and 5.0 months (95% CI: 2.9–7.1) in groups A, B and C, respectively, and overall survival was 16.5 months (95% CI: 15.0–18.1), 8.4 months (95% CI: 6.0–10.8) and 10.5 months (95% CI: 7.5–13.6), respectively (group A vs. group B: p < 0.001; group A vs. group C: p = 0.0023). Adverse events of grade 3/4 occurred in 34% of patients in group A. Conclusions. Although sorafenib is a SOC in patients with BCLC stage C HCC, TACE is frequently used as an additional locoregional treatment in selected patients. This combined approach resulted in a significant overall survival benefit in selected patients, although randomized trials have not yet proven this benefit.