Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization

Abstract Background Switching to systemic therapy after transarterial chemoembolization (TACE) refractoriness is more inclined to preserve liver function and decrease disease progression. Hence, we conducted a comparison between the advantages of sorafenib therapy and the continuation of TACE in pat...

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Main Authors: Reham Ashour, Eman Rewisha, Mohamed AKL Rady, Sally Waheed Elkhadry, Heba Abdelhalim, Mohamed Atef
Format: Article
Language:English
Published: BMC 2024-11-01
Series:BMC Cancer
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Online Access:https://doi.org/10.1186/s12885-024-13199-1
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author Reham Ashour
Eman Rewisha
Mohamed AKL Rady
Sally Waheed Elkhadry
Heba Abdelhalim
Mohamed Atef
author_facet Reham Ashour
Eman Rewisha
Mohamed AKL Rady
Sally Waheed Elkhadry
Heba Abdelhalim
Mohamed Atef
author_sort Reham Ashour
collection DOAJ
description Abstract Background Switching to systemic therapy after transarterial chemoembolization (TACE) refractoriness is more inclined to preserve liver function and decrease disease progression. Hence, we conducted a comparison between the advantages of sorafenib therapy and the continuation of TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) who developed TACE refractoriness. Methods This retrospective cohort work involved 1,200 patients with HCC who received TACE therapy at our institution between January 2018 and December 2022. Out of these, a total of 436 participants were determined to be resistant to TACE treatment throughout their clinical progression. Out of them, 271 were finally included and categorized into two groups: (1) patients who shifted from TACE to sorafenib, and (2) patients who maintained TACE treatment. The study assessed the overall survival (OS) and time to disease progression (TTDP) of patients who were resistant to TACE, comparing both groups based on when they achieved Child-Pugh C or acquired advanced-stage HCC. Results Following confirmation of refractoriness to TACE therapy, 163 opted to continue with TACE (TACE group), whereas 108 shifted to sorafenib treatment (sorafenib group). The median TTDP was 23.36 months, while the median OS was 25.3 months, in the sorafenib group, and 11.6 and 14.2 months, correspondingly, in the TACE group (p = 0.0001). Conclusion Switching to sorafenib treatment significantly improved OS and TTDP in patients with intermediate-stage HCC who were refractory to TACE. These finding highlights sorafenib’s potential as an effective alternative for managing disease progression in patients unresponsive to TACE, offering a valuable treatment option in this challenging clinical scenario.
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spelling doaj-art-c986d517cc604dcfb46cad2fb6ae7a162025-08-20T02:49:15ZengBMCBMC Cancer1471-24072024-11-0124111710.1186/s12885-024-13199-1Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolizationReham Ashour0Eman Rewisha1Mohamed AKL Rady2Sally Waheed Elkhadry3Heba Abdelhalim4Mohamed Atef5Department of Hepatology and Gastroenterology, National Liver Institute, Menoufia UniversityDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia UniversityDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia UniversityDepartment of Epidemiology and Preventive Medicine, National Liver Institute, Menoufia UniversityDepartment of Diagnostic Medical Imaging and Interventional Radiology, National Liver Institute, Menoufia UniversityDepartment of Hepatology and Gastroenterology, National Liver Institute, Menoufia UniversityAbstract Background Switching to systemic therapy after transarterial chemoembolization (TACE) refractoriness is more inclined to preserve liver function and decrease disease progression. Hence, we conducted a comparison between the advantages of sorafenib therapy and the continuation of TACE in patients with intermediate-stage hepatocellular carcinoma (HCC) who developed TACE refractoriness. Methods This retrospective cohort work involved 1,200 patients with HCC who received TACE therapy at our institution between January 2018 and December 2022. Out of these, a total of 436 participants were determined to be resistant to TACE treatment throughout their clinical progression. Out of them, 271 were finally included and categorized into two groups: (1) patients who shifted from TACE to sorafenib, and (2) patients who maintained TACE treatment. The study assessed the overall survival (OS) and time to disease progression (TTDP) of patients who were resistant to TACE, comparing both groups based on when they achieved Child-Pugh C or acquired advanced-stage HCC. Results Following confirmation of refractoriness to TACE therapy, 163 opted to continue with TACE (TACE group), whereas 108 shifted to sorafenib treatment (sorafenib group). The median TTDP was 23.36 months, while the median OS was 25.3 months, in the sorafenib group, and 11.6 and 14.2 months, correspondingly, in the TACE group (p = 0.0001). Conclusion Switching to sorafenib treatment significantly improved OS and TTDP in patients with intermediate-stage HCC who were refractory to TACE. These finding highlights sorafenib’s potential as an effective alternative for managing disease progression in patients unresponsive to TACE, offering a valuable treatment option in this challenging clinical scenario.https://doi.org/10.1186/s12885-024-13199-1Hepatocellular carcinomaSorafenibTransarterial chemoembolizationRefractornessIntermediate-stage patients
spellingShingle Reham Ashour
Eman Rewisha
Mohamed AKL Rady
Sally Waheed Elkhadry
Heba Abdelhalim
Mohamed Atef
Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
BMC Cancer
Hepatocellular carcinoma
Sorafenib
Transarterial chemoembolization
Refractorness
Intermediate-stage patients
title Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
title_full Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
title_fullStr Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
title_full_unstemmed Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
title_short Effectiveness of sorafenib in treating intermediate-stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
title_sort effectiveness of sorafenib in treating intermediate stage hepatocellular carcinoma patients refractory to transarterial chemoembolization
topic Hepatocellular carcinoma
Sorafenib
Transarterial chemoembolization
Refractorness
Intermediate-stage patients
url https://doi.org/10.1186/s12885-024-13199-1
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