Yu-Yun Shao1, Chih-Horng Wu2, Li-Chun Lu3, Soa-Yu Chan4, Yu-Yi Ma5, Feng-Chu Yen5, Chih-Hung Hsu6, Ann-Lii Cheng7. 1. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan. 2. Department of Medical Imaging, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Imaging, National Taiwan University Hospital, Hsin-Chu Branch, Hsinchu, Taiwan. 3. Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan. 4. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan. 5. National Taiwan University Cancer Center Preparatory Office, National Taiwan University College of Medicine, Taipei, Taiwan. 6. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: chihhunghsu@ntu.edu.tw. 7. Department of Oncology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Oncology, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: alcheng@ntu.edu.tw.
Abstract
BACKGROUND & AIMS: No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear. METHODS: All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure. RESULTS: A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ≤4. After the failure of the first-line therapy, the median OS of the entire group was 4.0 months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C=7.5 vs. 1.3 vs. 1.0 month, p<0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%-56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8-8.6 months. CONCLUSIONS: Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials.
BACKGROUND & AIMS: No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear. METHODS: All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure. RESULTS: A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ≤4. After the failure of the first-line therapy, the median OS of the entire group was 4.0 months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C=7.5 vs. 1.3 vs. 1.0 month, p<0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%-56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8-8.6 months. CONCLUSIONS:Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials.
Keywords:
BCLC; Barcelona Clinic Liver Cancer; CLIP; Cancer of the Liver Italian Program; Clinical trials; ECOG PS; Eastern Cooperative Oncology Group performance status; HCC; Hepatocellular carcinoma; NTUH; National Taiwan University Hospital; OS; Prognosis; Second-line therapy; Survival; TTP; hepatocellular carcinoma; overall survival; time to progression
Authors: Hye Won Lee; Hyun Soo Kim; Seung Up Kim; Do Young Kim; Beom Kyung Kim; Jun Yong Park; Sang Hoon Ahn; Mi Young Jeon; Ja Yoon Heo; Soo Young Park; Yu Rim Lee; Sun Kyung Jang; Su Hyun Lee; Se Young Jang; Won Young Tak; Kwang-Hyub Han Journal: Gut Liver Date: 2017-09-15 Impact factor: 4.519
Authors: Franco Trevisani; Giovanni Brandi; Francesca Garuti; Maria Aurelia Barbera; Raffaella Tortora; Andrea Casadei Gardini; Alessandro Granito; Francesco Tovoli; Stefania De Lorenzo; Andrea Lorenzo Inghilesi; Francesco Giuseppe Foschi; Mauro Bernardi; Fabio Marra; Rodolfo Sacco; Giovan Giuseppe Di Costanzo Journal: J Cancer Res Clin Oncol Date: 2017-12-16 Impact factor: 4.322