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Older, younger patients with HCC see similar efficacy with sorafenib

Elderly patients with hepatocellular carcinoma taking sorafenib fared as well as younger patients, according to results published in the European Journal of Gastroenterology and Hepatology.

“Our study indicates that patients with advanced HCC aged more than 75 years had similar frequency and severity of drug-associated toxicities compared with younger individuals,” Dimitrios C. Ziogas, MD, PhD, of the department of clinical therapeutics at the University of Athens, Greece, and colleagues wrote.

Researchers retrospectively studied OS and time to treatment failure (TTF) of 190 patients aged 26 to 87 years. They placed patients into two groups — 75 years or younger (n = 151) or 75 years or older (n = 39).

Researchers found in the younger group:

• 131 received the initial approved dose of 400 mg/day of sorafenib (Bayer);
• 103 experienced treatment failure caused by radiological disease progression, toxicity, or their choosing to terminate treatment;
• 125 died during follow-up;
• median TTF was 4.2 months; and
• median OS was 7.1 months.

And in the older group:

• 30 received an initial dose of 400 mg/day of sorafenib;
• 26 experienced treatment failure caused by radiological disease progression toxicity, or their choosing to terminate treatment;
• 31 died during follow-up;
• median TTF was 5.6 months; and
• median OS was 10.4 months.

Patients with Child-Pugh B7 or B8 score at onset had a shorter TTF (adjusted HR = 4.64; 95% CI, 2.55–8.42) and a shorter OS (adjusted HR = 2.17, 95% CI, 1.24–3.7) than those with Child-Pugh A.

“We have shown that age alone should not be a discriminating factor for the management of patients with advanced HCC being considered for sorafenib,” Ziogas and colleagues wrote. “We therefore recommend that patients with advanced HCC of more than 75 years of age should ideally undergo screening with an appropriate validated geriatric assessment tool and those at risk should undergo a formal review to optimize conditions before the initiation of systemic treatment.” – by Janel Miller

Disclosures: Ziogas reports no relevant financial disclosures. Please see the study for a list of all other researchers’ relevant financial disclosures.