Atsushi Naganuma1,2, Takashi Hoshino3, Nozomi Ohno4, Yusuke Ogawa2, Tatsuma Murakami3, Suguru Horiguchi3, Daisuke Uehara3,5, Yuhei Suzuki3,6, Takeshi Hatanaka3,7, Tomohiro Kudo3,2, Hiroshi Ishihara3, Ken Sato5, Satoru Kakizaki5, Hitoshi Takagi8. 1. Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan naganuma2000@gmail.com. 2. Nutrition Support Team, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan. 3. Department of Gastroenterology, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan. 4. Nursing Department, Takasaki General Medical Center, National Hospital Organization, Takasaki, Japan. 5. Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan. 6. Department of Gastroenterology, Maebashi Red Cross Hospital, Maebashi, Japan. 7. Department of Gastroenterology, Gunma ken Saiseikai Maebashi Hospital, Maebashi, Japan. 8. Department of Gastroenterology, Kusunoki Hospital, Fujioka, Japan.
Abstract
BACKGROUND/AIM: Sorafenib is standard treatment for advanced hepatocellular carcinoma (HCC). Hand-foot skin reaction (HFSR) is a notorious side-effect of this therapy. This study evaluated prophylactic benefits of an oral nutritional supplement (ONS) on sorafenib-associated HFSR in advanced HCC. PATIENTS AND METHODS: This was a prospective, single-center, open-label trial arm using combined ONS and sorafenib in patients with unresectable HCC from August 2014 to February 2018. Control patients received sorafenib without ONS from 2011 to 2014. From September 2014, prophylactic ONS containing β-hydroxy-β-methylbutyrate (HMB), L-arginine, and L-glutamine was given. Sorafenib dosage was 400 mg/day for both groups. RESULTS: Each group comprised 22 men and three women. Age, sex, Child-Pugh score, and clinical stage excluding IV-B did not significantly differ between the groups. HFSR occurred after 2 weeks: 15/25 patients in the control group (60%; HFSR grade 1: 6, grade 2: 7, grade 3: 2) vs. 8/25 in the ONS group (32%; HFSR grade 1: 4, grade 2: 4, grade 3: 0; p=0.047, Pearson's Chi-square test). CONCLUSION: Prophylactic HMB, L-arginine and L-glutamine supplementation effectively prevented sorafenib-associated HFSR in patients with advanced HCC. Copyright
BACKGROUND/AIM: Sorafenib is standard treatment for advanced hepatocellular carcinoma (HCC). Hand-foot skin reaction (HFSR) is a notorious side-effect of this therapy. This study evaluated prophylactic benefits of an oral nutritional supplement (ONS) on sorafenib-associated HFSR in advanced HCC. PATIENTS AND METHODS: This was a prospective, single-center, open-label trial arm using combined ONS and sorafenib in patients with unresectable HCC from August 2014 to February 2018. Control patients received sorafenib without ONS from 2011 to 2014. From September 2014, prophylactic ONS containing β-hydroxy-β-methylbutyrate (HMB), L-arginine, and L-glutamine was given. Sorafenib dosage was 400 mg/day for both groups. RESULTS: Each group comprised 22 men and three women. Age, sex, Child-Pugh score, and clinical stage excluding IV-B did not significantly differ between the groups. HFSR occurred after 2 weeks: 15/25 patients in the control group (60%; HFSR grade 1: 6, grade 2: 7, grade 3: 2) vs. 8/25 in the ONS group (32%; HFSR grade 1: 4, grade 2: 4, grade 3: 0; p=0.047, Pearson's Chi-square test). CONCLUSION: Prophylactic HMB, L-arginine and L-glutamine supplementation effectively prevented sorafenib-associated HFSR in patients with advanced HCC. Copyright
Authors: Carla M Prado; Camila E Orsso; Suzette L Pereira; Philip J Atherton; Nicolaas E P Deutz Journal: J Cachexia Sarcopenia Muscle Date: 2022-03-17 Impact factor: 12.063