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Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs

BACKGROUND: Despite atezolizumab and bevacizumab (A + B) is currently the first‐line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. OBJECTIVE: To...

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Autores principales: Díaz‐González, Álvaro, Sapena, Víctor, Boix, Loreto, Torres, Ferrán, Sanduzzi‐Zamparelli, Marco, Da Fonseca, Leonardo G., LLarch, Neus, Iserte, Gemma, Guedes, Cassia, Muñoz‐Martínez, Sergio, Darnell, Anna, Belmonte, Ernest, Rimola, Jordi, Forner, Alejandro, Ayuso, Carmen, Bruix, Jordi, Reig, María
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280813/
https://www.ncbi.nlm.nih.gov/pubmed/34228394
http://dx.doi.org/10.1002/ueg2.12111
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author Díaz‐González, Álvaro
Sapena, Víctor
Boix, Loreto
Torres, Ferrán
Sanduzzi‐Zamparelli, Marco
Da Fonseca, Leonardo G.
LLarch, Neus
Iserte, Gemma
Guedes, Cassia
Muñoz‐Martínez, Sergio
Darnell, Anna
Belmonte, Ernest
Rimola, Jordi
Forner, Alejandro
Ayuso, Carmen
Bruix, Jordi
Reig, María
author_facet Díaz‐González, Álvaro
Sapena, Víctor
Boix, Loreto
Torres, Ferrán
Sanduzzi‐Zamparelli, Marco
Da Fonseca, Leonardo G.
LLarch, Neus
Iserte, Gemma
Guedes, Cassia
Muñoz‐Martínez, Sergio
Darnell, Anna
Belmonte, Ernest
Rimola, Jordi
Forner, Alejandro
Ayuso, Carmen
Bruix, Jordi
Reig, María
author_sort Díaz‐González, Álvaro
collection PubMed
description BACKGROUND: Despite atezolizumab and bevacizumab (A + B) is currently the first‐line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. OBJECTIVE: To characterize the early diarrhoea development as prognostic factor in 344 HCC patients. METHODS: The development of early diarrhoea in sorafenib treatment defined as patients who developed diarrhoea and needed dose modification within the first 60 days of treatment (e‐diarrhoea) and 3‐grouping variables were analysed: Patients with e‐diarrhoea, patients who developed diarrhoea after the first 60 days of treatment (L‐diarrhoea) and patients that never developed diarrhoea (never diarrhoea). RESULTS: The median overall survival in sorafenib treated patients was significantly different across groups (6.8 months for e‐diarrhoea, 26.7 months for L‐diarrhoea and 13.3 months for never‐diarrhoea). The emergence of e‐diarrhoea was associated with poor outcomes (hazard ratio [HR] 1.84 [95%CI 1.15–2.95]), while there was no increased/decreased risk of dismal evolution in patients with L‐diarrhoea (HR 0.66 [95%CI 0.42–1.03]). CONCLUSION: The emergence of e‐diarrhoea in HCC patients treated with sorafenib is an early predictor of dismal evolution under this therapy. Thus, prompt identification of these non‐responders may be useful for an early switch to second‐line therapies.
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spelling pubmed-82808132021-07-16 Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs Díaz‐González, Álvaro Sapena, Víctor Boix, Loreto Torres, Ferrán Sanduzzi‐Zamparelli, Marco Da Fonseca, Leonardo G. LLarch, Neus Iserte, Gemma Guedes, Cassia Muñoz‐Martínez, Sergio Darnell, Anna Belmonte, Ernest Rimola, Jordi Forner, Alejandro Ayuso, Carmen Bruix, Jordi Reig, María United European Gastroenterol J Hepatobiliary BACKGROUND: Despite atezolizumab and bevacizumab (A + B) is currently the first‐line treatment for hepatocellular carcinoma (HCC) patients, some patients will not be adequate for this combination. In the setting of sorafenib some adverse events have been proposed as prognostic factors. OBJECTIVE: To characterize the early diarrhoea development as prognostic factor in 344 HCC patients. METHODS: The development of early diarrhoea in sorafenib treatment defined as patients who developed diarrhoea and needed dose modification within the first 60 days of treatment (e‐diarrhoea) and 3‐grouping variables were analysed: Patients with e‐diarrhoea, patients who developed diarrhoea after the first 60 days of treatment (L‐diarrhoea) and patients that never developed diarrhoea (never diarrhoea). RESULTS: The median overall survival in sorafenib treated patients was significantly different across groups (6.8 months for e‐diarrhoea, 26.7 months for L‐diarrhoea and 13.3 months for never‐diarrhoea). The emergence of e‐diarrhoea was associated with poor outcomes (hazard ratio [HR] 1.84 [95%CI 1.15–2.95]), while there was no increased/decreased risk of dismal evolution in patients with L‐diarrhoea (HR 0.66 [95%CI 0.42–1.03]). CONCLUSION: The emergence of e‐diarrhoea in HCC patients treated with sorafenib is an early predictor of dismal evolution under this therapy. Thus, prompt identification of these non‐responders may be useful for an early switch to second‐line therapies. John Wiley and Sons Inc. 2021-07-06 /pmc/articles/PMC8280813/ /pubmed/34228394 http://dx.doi.org/10.1002/ueg2.12111 Text en © 2021 The Authors. United European Gastroenterology Journal published by Wiley Periodicals LLC. on behalf of United European Gastroenterology. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Hepatobiliary
Díaz‐González, Álvaro
Sapena, Víctor
Boix, Loreto
Torres, Ferrán
Sanduzzi‐Zamparelli, Marco
Da Fonseca, Leonardo G.
LLarch, Neus
Iserte, Gemma
Guedes, Cassia
Muñoz‐Martínez, Sergio
Darnell, Anna
Belmonte, Ernest
Rimola, Jordi
Forner, Alejandro
Ayuso, Carmen
Bruix, Jordi
Reig, María
Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title_full Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title_fullStr Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title_full_unstemmed Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title_short Early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
title_sort early diarrhoea under sorafenib as a marker to consider the early migration to second‐line drugs
topic Hepatobiliary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8280813/
https://www.ncbi.nlm.nih.gov/pubmed/34228394
http://dx.doi.org/10.1002/ueg2.12111
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