Andrea Mancuso1, Alessandra Mazzola2, Giuseppe Cabibbo2, Giovanni Perricone3, Marco Enea4, Antonio Galvano5, Claudio Zavaglia3, Luca Belli3, Calogero Cammà6. 1. Hepatology and Gastroenterology Department, Ospedale Niguarda Ca' Granda, Milano, Italy; Internal Medicine Department, Azienda di Rilievo Nazionale ad Alta Specializzazione Civico - Di Cristina - Benfratelli, Palermo, Italy. 2. Gastroenterology Unit, Internal Medicine Department, University of Palermo, Palermo, Italy. 3. Hepatology and Gastroenterology Department, Ospedale Niguarda Ca' Granda, Milano, Italy. 4. "S Vianelli" Department, University of Palermo, Italy. 5. Oncology Department, University of Palermo, Italy. 6. Gastroenterology Unit, Internal Medicine Department, University of Palermo, Palermo, Italy. Electronic address: calogero.camma@unipa.it.
Abstract
BACKGROUND: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. AIM: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. METHODS: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. RESULTS: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in patients undergoing m-Tor inhibitor therapy. The pooled estimate of 1-year survival was 63%. There was a significant heterogeneity among studies (P < 0.0001). Among the 34 variables assessed by univariate meta-regression, 5 were associated with an increase in the 1-year survival rate: (1) male gender (P = 0.001); (2) Time to progression (P = 0.038); and adverse drug events, divided in (3) gastrointestinal (P = 0.038), (4) cardiovascular (P = 0.029), and (5) dermatological (P = 0.014). CONCLUSIONS: Additional data from multicentre prospective studies are required to clearly determine if sorafenib is a safe and acceptable treatment in hepatocellular carcinoma recurrence after liver transplant. Nevertheless, its association with m-Tor inhibitors should be discouraged.
BACKGROUND: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. AIM: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. METHODS: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. RESULTS: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in patients undergoing m-Tor inhibitor therapy. The pooled estimate of 1-year survival was 63%. There was a significant heterogeneity among studies (P < 0.0001). Among the 34 variables assessed by univariate meta-regression, 5 were associated with an increase in the 1-year survival rate: (1) male gender (P = 0.001); (2) Time to progression (P = 0.038); and adverse drug events, divided in (3) gastrointestinal (P = 0.038), (4) cardiovascular (P = 0.029), and (5) dermatological (P = 0.014). CONCLUSIONS: Additional data from multicentre prospective studies are required to clearly determine if sorafenib is a safe and acceptable treatment in hepatocellular carcinoma recurrence after liver transplant. Nevertheless, its association with m-Tor inhibitors should be discouraged.
Authors: Li Gong; Marilyn M Giacomini; Craig Giacomini; Michael L Maitland; Russ B Altman; Teri E Klein Journal: Pharmacogenet Genomics Date: 2017-06 Impact factor: 2.089
Authors: Matteo Ravaioli; Alessandro Cucchetti; Antonio Daniele Pinna; Vanessa De Pace; Flavia Neri; Maria Aurelia Barbera; Lorenzo Maroni; Giorgio Frega; Andrea Palloni; Stefania De Lorenzo; Maria Cristina Ripoli; Maria Abbondanza Pantaleo; Matteo Cescon; Massimo Del Gaudio; Giovanni Brandi Journal: Sci Rep Date: 2017-09-12 Impact factor: 4.379