6533b82afe1ef96bd128cc05

RESEARCH PRODUCT

Optimizing Sequential Systemic Therapies for Advanced Hepatocellular Carcinoma: A Decision Analysis

Antonio CraxìGiacomo Emanuele Maria RizzoMassimo AttanasioSalvatore BattagliaDomenica MatrangaCiro CelsaGiuseppe CabibboMarco EneaCalogero CammàStefania GrimaudoPaolo Bruzzi

subject

SorafenibOncologyCancer Researchmedicine.medical_specialtySurvivalBevacizumabHepatocellular carcinomaSequential therapylcsh:RC254-282ArticleSettore MED/01 - Statistica MedicaRamucirumab03 medical and health scienceschemistry.chemical_compound0302 clinical medicineSettore BIO/13 - Biologia ApplicataAtezolizumabInternal medicineRegorafenibmedicineSettore SECS-S/05 - Statistica SocialeSettore MED/12 - GastroenterologiaSystemic therapybusiness.industrylcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogensTumor progressionClinical trialOncologychemistry030220 oncology & carcinogenesis030211 gastroenterology & hepatologyNivolumabLenvatinibbusinessmedicine.drug

description

Background: An optimal sequential systemic therapy for advanced hepatocellular carcinoma (HCC) has not been discovered. We developed a decision model based on available clinical trials to identify an optimal risk/benefit strategy for sequences of novel systemic agents. Methods: A Markov model was built to simulate overall survival (OS) among patients with advanced HCC. Three first-line (single-agent Sorafenib or Lenvatinib, and combination of Atezolizumab plus Bevacizumab) followed by five second-line treatments (Regorafenib, Cabozantinib, Ramucirumab, Nivolumab, Pembrolizumab) were compared in fifteen sequential strategies. The likelihood of transition between states (initial treatment, cancer progression, death) was derived from clinical trials. Life-year gained (LYG) was the main outcome. Rates of severe adverse events (SAEs) (&ge

yearjournalcountryeditionlanguage
2020-07-31Cancers
https://doi.org/10.3390/cancers12082132