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RESEARCH PRODUCT
Regorafenib Efficacy After Sorafenib in Patients With Recurrent Hepatocellular Carcinoma After Liver Transplantation:A Retrospective Study
Matthias PinterPietro LamperticoAinhoa Fernandez YunqueraGabriel Aballay SoterasMiguel Fraile-lópezTommy IvanicsMaria ReigMassimo IavaroneÁLvaro Díaz-gonzálezMaria VarelaLucia CesariniVincenzo MazzaferroGerda Elisabeth VilladsenFederica InvernizziMatteo Angelo ManiniMarcus A. WörnsMaria Jose Blanco RodríguezMario Romero CristóbalHelene RegnaultGiovanni Giuseppe Di CostanzoJordi BruixSherrie BhooriPeter Daechul YoonArndt WeinmannMarco Sanduzzi-zamparelliLuigia ScudellerMaria Francesca DonatoGonzalo SapisochinGiuliana AmaddeoStefano MazzaCarolin CzaudernaGonzalo CrespoClaudio ZavagliaMassimo De GiorgioMargarita AndersMaría Luisa González-diéguezRebecca PrinceR. TortoraFederico Piñerosubject
OncologySorafenibmedicine.medical_specialtyCarcinoma HepatocellularPyridinesmedicine.medical_treatmentAntineoplastic AgentsLiver transplantationchemistry.chemical_compoundRegorafenibInternal medicineClinical endpointmedicineHumansRetrospective StudiesTransplantationHepatologybusiness.industryPhenylurea CompoundsLiver NeoplasmsRetrospective cohort studySorafenibmedicine.diseaseRecurrent Hepatocellular Carcinomadigestive system diseasesLiver TransplantationDiscontinuationchemistryHepatocellular carcinomaSurgerybusinessmedicine.drugdescription
Background and aim Safety of regorafenib in hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been recently demonstrated. We aimed to assess the survival benefit of regorafenib compared to best supportive care (BSC) in LT-patients after sorafenib discontinuation. Methods This observational multicenter retrospective study included LT-patients with HCC-recurrence who discontinued first-line sorafenib. Group-1 was constituted by regorafenib-treated patients, while control group was selected among patients treated with best supportive care (BSC) due to unavailability of second-line options at the time of sorafenib discontinuation and who were sorafenib-tolerant progressors (group-2). Primary endpoint was overall survival (OS) of group-1 compared to group-2. Secondary endpoints were safety and OS of sequential treatment sorafenib+regorafenib/BSC. Results Among 132 LT-patients who discontinued sorafenib included in the study, 81 patients were sorafenib-tolerant: 36 received regorafenib (group-1) and 45 (group-2) received BSC. Overall, 24 (67%) patients died in group-1 and 40 (89%) in group-2: the median OS was significantly longer in group-1 than in group-2 (13.1 vs 5.5 months; p=0.002). Regorafenib treatment was an independent predictor of reduced mortality (HR 0.37, 95%CI 0.16-0.89, p=0.02). Median treatment duration with regorafenib was 7.0 (95%CI 5.5-8.5) months; regorafenib dose was reduced in 22 (61%) patients for adverse events and discontinued for tumor progression in 93%. The median OS calculated from sorafenib start was 28.8 months (95%CI: 17.6-40.1) in group-1 vs 15.3 months (95%CI: 8.8-21.7) in group-2 (p=0.002). Conclusions Regorafenib is an effective second-line treatment after sorafenib in patients with HCC-recurrence after LT.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2021-12-01 |