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Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma
Background: Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease...
Autores principales: | , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770447/ https://www.ncbi.nlm.nih.gov/pubmed/31461985 http://dx.doi.org/10.3390/cancers11091256 |
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author | Takada, Hitomi Kurosaki, Masayuki Tsuchiya, Kaoru Komiyama, Yasuyuki Itakura, Jun Takahashi, Yuka Nakanishi, Hiroyuki Yasui, Yutaka Tamaki, Nobuharu Maeyashiki, Chiaki Kaneko, Shun Takaura, Kenta Higuchi, Mayu Okada, Mao Wang, Wan Osawa, Leona Sekiguchi, Shuhei Hayakawa, Yuka Yamashita, Koji Enomoto, Nobuyuki Izumi, Namiki |
author_facet | Takada, Hitomi Kurosaki, Masayuki Tsuchiya, Kaoru Komiyama, Yasuyuki Itakura, Jun Takahashi, Yuka Nakanishi, Hiroyuki Yasui, Yutaka Tamaki, Nobuharu Maeyashiki, Chiaki Kaneko, Shun Takaura, Kenta Higuchi, Mayu Okada, Mao Wang, Wan Osawa, Leona Sekiguchi, Shuhei Hayakawa, Yuka Yamashita, Koji Enomoto, Nobuyuki Izumi, Namiki |
author_sort | Takada, Hitomi |
collection | PubMed |
description | Background: Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease progression during sorafenib treatment. Methods: This is a retrospective cohort study of 190 consecutive HCC patients who were treated with sorafenib in our hospital. Three criteria of good candidates for second-line TKI at the time of disease progression during sorafenib treatment were defined as follows: criterion 1 was the same as the inclusion criteria of the regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE) study, criterion 2 was the inclusion criteria of the RESORCE study plus Child–Pugh score 5, and criterion 3 was the inclusion criteria of the RESORCE study plus albumin–bilirubin (ALBI) grade 1. Factors at baseline and at week 4 during sorafenib treatment were used to predict patients fulfilling each of these three criteria. Results: The distribution of patients was 29%, 13%, and 6% in criteria 1, 2, and 3, respectively. Significant factors for meeting criterion 1 was the combination of baseline albumin >3.7 g/dL (odds ratio (OR) 2.7) plus degree of decrease in albumin (Δalbumin) at week 4 <0.2 g/dL (OR 2.6), or the combination of baseline ALBI score <−2.33 (OR 2.5) and ΔALBI at week 4 <0.255 (OR 4.9). For criterion 2, the value of baseline albumin and ALBI score was identical to criterion 1; however, Δalbumin (<0.1 g/dL) and ΔALBI score (<0.19) became stricter. For criterion 3, the value of baseline albumin (>3.8 g/dL) and ALBI (<−2.55) became stricter, as did Δalbumin (<0.1 g/dL) and ΔALBI (<0.085). Furthermore, tumor burden (>11) was selected as an additional predictor (OR 5.4). Conclusion: Predictors to satisfy the RESORCE study inclusion criteria were as follows: preserved liver function at baseline, as reflected by albumin or ALBI score, and small deterioration of liver function early during sorafenib therapy, as reflected by Δalbumin or ΔALBI at week 4. Liver function at baseline and degree of change in liver function during sorafenib treatment need to be stricter for better outcomes of liver function with disease progression. |
format | Online Article Text |
id | pubmed-6770447 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-67704472019-10-30 Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma Takada, Hitomi Kurosaki, Masayuki Tsuchiya, Kaoru Komiyama, Yasuyuki Itakura, Jun Takahashi, Yuka Nakanishi, Hiroyuki Yasui, Yutaka Tamaki, Nobuharu Maeyashiki, Chiaki Kaneko, Shun Takaura, Kenta Higuchi, Mayu Okada, Mao Wang, Wan Osawa, Leona Sekiguchi, Shuhei Hayakawa, Yuka Yamashita, Koji Enomoto, Nobuyuki Izumi, Namiki Cancers (Basel) Article Background: Recent advances in the development of tyrosine kinase inhibitors (TKIs) have enabled patients with unresectable hepatocellular carcinoma (HCC) to receive multiple TKIs in sequence. The aim of this study was to identify predictors of good candidates for second-line treatment after disease progression during sorafenib treatment. Methods: This is a retrospective cohort study of 190 consecutive HCC patients who were treated with sorafenib in our hospital. Three criteria of good candidates for second-line TKI at the time of disease progression during sorafenib treatment were defined as follows: criterion 1 was the same as the inclusion criteria of the regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE) study, criterion 2 was the inclusion criteria of the RESORCE study plus Child–Pugh score 5, and criterion 3 was the inclusion criteria of the RESORCE study plus albumin–bilirubin (ALBI) grade 1. Factors at baseline and at week 4 during sorafenib treatment were used to predict patients fulfilling each of these three criteria. Results: The distribution of patients was 29%, 13%, and 6% in criteria 1, 2, and 3, respectively. Significant factors for meeting criterion 1 was the combination of baseline albumin >3.7 g/dL (odds ratio (OR) 2.7) plus degree of decrease in albumin (Δalbumin) at week 4 <0.2 g/dL (OR 2.6), or the combination of baseline ALBI score <−2.33 (OR 2.5) and ΔALBI at week 4 <0.255 (OR 4.9). For criterion 2, the value of baseline albumin and ALBI score was identical to criterion 1; however, Δalbumin (<0.1 g/dL) and ΔALBI score (<0.19) became stricter. For criterion 3, the value of baseline albumin (>3.8 g/dL) and ALBI (<−2.55) became stricter, as did Δalbumin (<0.1 g/dL) and ΔALBI (<0.085). Furthermore, tumor burden (>11) was selected as an additional predictor (OR 5.4). Conclusion: Predictors to satisfy the RESORCE study inclusion criteria were as follows: preserved liver function at baseline, as reflected by albumin or ALBI score, and small deterioration of liver function early during sorafenib therapy, as reflected by Δalbumin or ΔALBI at week 4. Liver function at baseline and degree of change in liver function during sorafenib treatment need to be stricter for better outcomes of liver function with disease progression. MDPI 2019-08-27 /pmc/articles/PMC6770447/ /pubmed/31461985 http://dx.doi.org/10.3390/cancers11091256 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Takada, Hitomi Kurosaki, Masayuki Tsuchiya, Kaoru Komiyama, Yasuyuki Itakura, Jun Takahashi, Yuka Nakanishi, Hiroyuki Yasui, Yutaka Tamaki, Nobuharu Maeyashiki, Chiaki Kaneko, Shun Takaura, Kenta Higuchi, Mayu Okada, Mao Wang, Wan Osawa, Leona Sekiguchi, Shuhei Hayakawa, Yuka Yamashita, Koji Enomoto, Nobuyuki Izumi, Namiki Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title | Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title_full | Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title_fullStr | Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title_full_unstemmed | Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title_short | Baseline and Early Predictors of Good Patient Candidates for Second-Line after Sorafenib Treatment in Unresectable Hepatocellular Carcinoma |
title_sort | baseline and early predictors of good patient candidates for second-line after sorafenib treatment in unresectable hepatocellular carcinoma |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770447/ https://www.ncbi.nlm.nih.gov/pubmed/31461985 http://dx.doi.org/10.3390/cancers11091256 |
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