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Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database

BACKGROUND: Sorafenib has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC), however, full dose can be difficult to tolerate. The aim of this study was to determine whether sorafenib starting dose and mean dose intensity affect survival. METHODS: Patients treate...

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Autores principales: Alghamdi, Mohammed A., Amaro, Carla P., Lee‐Ying, Richard, Sim, Hao‐Wen, Samwi, Haider, Chan, Kelvin K., Knox, Jennifer J., Ko, Yoo‐Joung, Swiha, Mina, Batuyong, Eugene, Romagnino, Adriana, Cheung, Winson Y., Tam, Vincent C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367626/
https://www.ncbi.nlm.nih.gov/pubmed/32529797
http://dx.doi.org/10.1002/cam4.3228
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author Alghamdi, Mohammed A.
Amaro, Carla P.
Lee‐Ying, Richard
Sim, Hao‐Wen
Samwi, Haider
Chan, Kelvin K.
Knox, Jennifer J.
Ko, Yoo‐Joung
Swiha, Mina
Batuyong, Eugene
Romagnino, Adriana
Cheung, Winson Y.
Tam, Vincent C.
author_facet Alghamdi, Mohammed A.
Amaro, Carla P.
Lee‐Ying, Richard
Sim, Hao‐Wen
Samwi, Haider
Chan, Kelvin K.
Knox, Jennifer J.
Ko, Yoo‐Joung
Swiha, Mina
Batuyong, Eugene
Romagnino, Adriana
Cheung, Winson Y.
Tam, Vincent C.
author_sort Alghamdi, Mohammed A.
collection PubMed
description BACKGROUND: Sorafenib has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC), however, full dose can be difficult to tolerate. The aim of this study was to determine whether sorafenib starting dose and mean dose intensity affect survival. METHODS: Patients treated with sorafenib for HCC from January 2008 to July 2016 in several Canadian provinces were included and retrospectively analyzed. The primary end point was overall survival (OS) of patients starting on sorafenib full dose compared to reduced dose. Secondary analysis compared OS with different mean dose‐intensity groups. Survival outcomes were assessed with Kaplan‐Meier curves and Cox proportional hazards models. A propensity score analysis was performed to account for treatment bias and confounding. RESULTS: Of 681 patients included, sorafenib was started at full dose in 289 patients (42%). Median survival for starting full and reduced dose was 9.4 months and 8.9 months (P = .15) respectively. After propensity score matching and adjusting for potential confounders there was still no difference in survival (HR 0.8, 95% CI, 0.61‐1.06, P = .12). Almost half of the patients (45%) received a dose intensity < 50%. Median survival for mean dose intensity > 75%, 50%‐75%, and < 50% were 9.5 months, 12.9 months, and 7.1 months (P = .005) respectively. In multivariable models, starting dose(HR 1.16, 95% CI 0.93‐1.44, P = .180) and mean dose intensity were not associated with survival. CONCLUSIONS: Starting HCC patients on a reduced dose of sorafenib compared to full dose may not compromise survival. Mean dose‐intensity of sorafenib may also not affect survival.
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spelling pubmed-73676262020-07-20 Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database Alghamdi, Mohammed A. Amaro, Carla P. Lee‐Ying, Richard Sim, Hao‐Wen Samwi, Haider Chan, Kelvin K. Knox, Jennifer J. Ko, Yoo‐Joung Swiha, Mina Batuyong, Eugene Romagnino, Adriana Cheung, Winson Y. Tam, Vincent C. Cancer Med Clinical Cancer Research BACKGROUND: Sorafenib has been shown to improve survival in patients with advanced hepatocellular carcinoma (HCC), however, full dose can be difficult to tolerate. The aim of this study was to determine whether sorafenib starting dose and mean dose intensity affect survival. METHODS: Patients treated with sorafenib for HCC from January 2008 to July 2016 in several Canadian provinces were included and retrospectively analyzed. The primary end point was overall survival (OS) of patients starting on sorafenib full dose compared to reduced dose. Secondary analysis compared OS with different mean dose‐intensity groups. Survival outcomes were assessed with Kaplan‐Meier curves and Cox proportional hazards models. A propensity score analysis was performed to account for treatment bias and confounding. RESULTS: Of 681 patients included, sorafenib was started at full dose in 289 patients (42%). Median survival for starting full and reduced dose was 9.4 months and 8.9 months (P = .15) respectively. After propensity score matching and adjusting for potential confounders there was still no difference in survival (HR 0.8, 95% CI, 0.61‐1.06, P = .12). Almost half of the patients (45%) received a dose intensity < 50%. Median survival for mean dose intensity > 75%, 50%‐75%, and < 50% were 9.5 months, 12.9 months, and 7.1 months (P = .005) respectively. In multivariable models, starting dose(HR 1.16, 95% CI 0.93‐1.44, P = .180) and mean dose intensity were not associated with survival. CONCLUSIONS: Starting HCC patients on a reduced dose of sorafenib compared to full dose may not compromise survival. Mean dose‐intensity of sorafenib may also not affect survival. John Wiley and Sons Inc. 2020-06-11 /pmc/articles/PMC7367626/ /pubmed/32529797 http://dx.doi.org/10.1002/cam4.3228 Text en © 2020 The Authors. Cancer Medicine published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Cancer Research
Alghamdi, Mohammed A.
Amaro, Carla P.
Lee‐Ying, Richard
Sim, Hao‐Wen
Samwi, Haider
Chan, Kelvin K.
Knox, Jennifer J.
Ko, Yoo‐Joung
Swiha, Mina
Batuyong, Eugene
Romagnino, Adriana
Cheung, Winson Y.
Tam, Vincent C.
Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title_full Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title_fullStr Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title_full_unstemmed Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title_short Effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: Results from a Canadian Multicenter Database
title_sort effect of sorafenib starting dose and dose intensity on survival in patients with hepatocellular carcinoma: results from a canadian multicenter database
topic Clinical Cancer Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7367626/
https://www.ncbi.nlm.nih.gov/pubmed/32529797
http://dx.doi.org/10.1002/cam4.3228
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