A Salman1, E Simoneau1, M Hassanain2, P Chaudhury3, L M Boucher4, D Valenti4, T Cabrera4, C Nudo5, P Metrakos3. 1. Department of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, McGill University, Montreal, QC. 2. Department of Oncology, McGill University, Montreal, QC; Department of Surgery, King Saud University, Riyadh, Saudi Arabia. 3. Department of Surgery, Division of Hepatopancreatobiliary and Transplant Surgery, McGill University, Montreal, QC; Department of Oncology, McGill University, Montreal, QC. 4. Department of Radiology, Division of Interventional Radiology, McGill University, Montreal, QC. 5. Department of Medicine, Division of Hepatology, McGill University, Montreal, QC.
Abstract
BACKGROUND AND AIMS: In this pilot study, we assessed the safety and tolerability of combining sorafenib with 90Y radioembolization for the treatment of unresectable hepatocellular carcinoma (hcc). METHODS: The study, conducted prospectively during 2009-2012, included eligible patients with unresectable hcc and a life expectancy of at least 12 weeks. Each patient received sorafenib (400 mg twice daily) for 6-8 weeks before 90Y treatment. Safety and tolerability were assessed. RESULTS: Of the 40 patients enrolled, 29 completed treatment (combined therapy). In the initial cohort, the most common cause of hcc was hepatitis C (32.5%), and most patients were staged Child A (82.5%). The 29 patients who completed the study had similar baseline characteristics. Grades 1 and 2 toxicities accounted for 77.8% of all adverse events reported. The most common toxicities reported were fatigue (19.0%), alteration in liver function (7.9%), and diarrhea (6.3%). There were 12 grade 3 and 2 grade 4 toxicity events reported. One patient died of liver failure within 30 days after treatment. During the study, the sorafenib dose was reduced in 6 patients (20.7%), and sorafenib had to be interrupted in 4 patients (13.8%) and discontinued in 4 patients (13.8%). The disease control rate was 72.4% per the modified Response Evaluation Criteria in Solid Tumors, and tumour necrosis was observed in 82.8% of patients. Overall survival in patients undergoing combined therapy was 12.4 months. CONCLUSIONS: Preliminary results demonstrate the safety and tolerability of combining 90Y radioembolization and sorafenib for advanced hcc. A larger prospective study is needed to determine the extent of the survival benefit.
BACKGROUND AND AIMS: In this pilot study, we assessed the safety and tolerability of combining sorafenib with 90Y radioembolization for the treatment of unresectable hepatocellular carcinoma (hcc). METHODS: The study, conducted prospectively during 2009-2012, included eligible patients with unresectable hcc and a life expectancy of at least 12 weeks. Each patient received sorafenib (400 mg twice daily) for 6-8 weeks before 90Y treatment. Safety and tolerability were assessed. RESULTS: Of the 40 patients enrolled, 29 completed treatment (combined therapy). In the initial cohort, the most common cause of hcc was hepatitis C (32.5%), and most patients were staged Child A (82.5%). The 29 patients who completed the study had similar baseline characteristics. Grades 1 and 2 toxicities accounted for 77.8% of all adverse events reported. The most common toxicities reported were fatigue (19.0%), alteration in liver function (7.9%), and diarrhea (6.3%). There were 12 grade 3 and 2 grade 4 toxicity events reported. One patient died of liver failure within 30 days after treatment. During the study, the sorafenib dose was reduced in 6 patients (20.7%), and sorafenib had to be interrupted in 4 patients (13.8%) and discontinued in 4 patients (13.8%). The disease control rate was 72.4% per the modified Response Evaluation Criteria in Solid Tumors, and tumour necrosis was observed in 82.8% of patients. Overall survival in patients undergoing combined therapy was 12.4 months. CONCLUSIONS: Preliminary results demonstrate the safety and tolerability of combining 90Y radioembolization and sorafenib for advanced hcc. A larger prospective study is needed to determine the extent of the survival benefit.
Authors: Arthur J A T Braat; Maarten L J Smits; Manon N G J A Braat; Andor F van den Hoven; Jip F Prince; Hugo W A M de Jong; Maurice A A J van den Bosch; Marnix G E H Lam Journal: J Nucl Med Date: 2015-05-07 Impact factor: 10.057
Authors: Bruno Sangro; Livio Carpanese; Roberto Cianni; Rita Golfieri; Daniele Gasparini; Samer Ezziddin; Philipp M Paprottka; Francesco Fiore; Mark Van Buskirk; Jose Ignacio Bilbao; Giuseppe Maria Ettorre; Rita Salvatori; Emanuela Giampalma; Onelio Geatti; Kai Wilhelm; Ralf Thorsten Hoffmann; Francesco Izzo; Mercedes Iñarrairaegui; Carlo Ludovico Maini; Carlo Urigo; Alberta Cappelli; Alessandro Vit; Hojjat Ahmadzadehfar; Tobias Franz Jakobs; Secondo Lastoria Journal: Hepatology Date: 2011-06-30 Impact factor: 17.425
Authors: M A D Vente; M Wondergem; I van der Tweel; M A A J van den Bosch; B A Zonnenberg; M G E H Lam; A D van Het Schip; J F W Nijsen Journal: Eur Radiol Date: 2008-11-07 Impact factor: 5.315
Authors: Laura M Kulik; Brian I Carr; Mary F Mulcahy; Robert J Lewandowski; Bassel Atassi; Robert K Ryu; Kent T Sato; Al Benson; Albert A Nemcek; Vanessa L Gates; Michael Abecassis; Reed A Omary; Riad Salem Journal: Hepatology Date: 2008-01 Impact factor: 17.425
Authors: Philip Chong-Hei Kwok; Kwong Chuen Leung; Moon Tong Cheung; Ting Wa Lam; Lok Tin Szeto; Sandas Qi-Hua Chou; Nam Hung Chia; Cheuk Man Tong; Pui Kei Yuen; Chun Hung Cheung; Chun Key Law Journal: J Gastroenterol Hepatol Date: 2014-11 Impact factor: 4.029
Authors: Nitesh Rana; Andrew Wenhua Ju; Michael Bazylewicz; Bhaskar Kallakury; Aiwu Ruth He; Keith R Unger; Justin S Lee Journal: Front Oncol Date: 2013-12-30 Impact factor: 6.244
Authors: Andrew Kennedy; Daniel B Brown; Jonas Feilchenfeldt; John Marshall; Harpreet Wasan; Marwan Fakih; Peter Gibbs; Alexander Knuth; Bruno Sangro; Michael C Soulen; Gianfranco Pittari; Ricky A Sharma Journal: J Gastrointest Oncol Date: 2017-12
Authors: Paul Blanc-Durand; Axel Van Der Gucht; Adrien Depeursinge; Niklaus Schaefer; Mario Jreige; Marie Nicod-Lalonde; Marina Silva-Monteiro; John O Prior; Alban Denys Journal: Oncotarget Date: 2017-12-19
Authors: Ajalaya Teyateeti; Armeen Mahvash; James P Long; Mohamed E Abdelsalam; Rony Avritscher; Beth Chasen; Ahmed O Kaseb; Joshua D Kuban; Ravi Murthy; Bruno C Odisio; Achiraya Teyateeti; Homer A Macapinlac; S Cheenu Kappadath Journal: J Hepatocell Carcinoma Date: 2020-09-14