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Sorafenib/RFA therapy improved OS, recurrence rates in HCC
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In a new study, patients with hepatocellular carcinoma who were treated with sorafenib plus radiofrequency ablation, or RFA, had increased overall survival and lower tumor recurrence rates vs. patients treated with RFA alone.
“The incidence of HCC is increasing in developed countries. … It is especially high in China, where more than 30 cases per 100,000 of the population occur per year,” the researchers wrote. “We evaluated the safety and efficacy of a combination sorafenib and RFA therapy in patients with Barcelona Clinic Liver Cancer stage 0-B1 HCC in a multicenter retrospective cohort study.”
Patients with HCC from 12 tertiary centers (n=128) were enrolled in the study and evenly divided to a dosage of 400 mg sorafenib (Nexavar; Bayer HealthCare/Onyx Pharmaceuticals) twice daily with RFA or treatment with RFA alone. The median time between first dose of sorafenib and HCC diagnosis was 46.5 weeks. The average time between the first dose of sorafenib and RFA treatment was 14.7 days, with a median of 10.5 days. Median follow-up was 134 weeks. Forty-five patients in the sorafenib/RFA group and 34 patients in the RFA alone group survived and were included in the final analysis.
Cumulative survival rates at 1 year were 80.7% in the RFA group vs. 85.6% in the sorafenib/RFA group; 47.2% vs. 64% at 2 years; 30.9% vs. 58.7% at 3 years; and 30.9% vs. 50.3% at 4 years. These rates showed that patients who underwent treatment with sorafenib and RFA lived longer compared with the patients who received just RFA treatment (P=.036).
Fewer patients who underwent treatment with sorafenib and RFA had tumor recurrences after the study period ended (29 vs. 48; P=.047). Cumulative recurrence rates were 40.5% in the sorafenib/RFA group vs. 62.8% in the control group at 1 year; 62.9% vs. 85.4% at 2 years; and 74.5% vs. 92.7% at 3 years.
Multivariate analyses showed sorafenib administration, tumor number, tumor-node metastasis (TNM) stage and tumor size to be predictors of overall survival. Previous transcatheter arterial chemoembolization therapy, anti-virus therapy, tumor number, TNM stage and sorafenib administration were independent risk factors for tumor recurrence.
“We found that sorafenib-RFA treatment was associated with a decreased incidence of liver recurrences and better OS than RFA alone,” the researchers concluded. “Sorafenib-RFA proved to be a safe and effective treatment for localized, small volume primary and recurrent HCC.”
Disclosure: The study was funded by the National S&T Major Project for Infectious Diseases of China and the State Key Program of National Natural Science Foundation of China.
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