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RESEARCH PRODUCT
Refining sorafenib therapy: lessons from clinical practice
Federico SpandonaroLuigi BolondiMassimo ColomboStefano FagiuoliGiovan Giuseppe Di CostanzoAntonio CraxìCorrado BoniRomano DanesiCalogero CammàArmando SantoroBruno DanielePaolo BruzziFranco Trevisanisubject
Cancer ResearchSettore SECS-P/06 - Economia ApplicataAntineoplastic AgentAge FactorChild–Pugh Bpostprogression treatmentresponse assessmentdose modificationClinical Trials as TopicLiver Neoplasmsadverse event managementAge FactorsChild-Pugh Bpostprogression treatmenthepatocellular carcinomaGeneral MedicinePrognosisadverse event management; child–Pugh B; dose modification; elderly hepatocellular carcinoma; mRECIST; postprogression treatment; eal-world data; response assessment; sorafenibelderly hepatocellular carcinomaCombined Modality Therapychild–Pugh BClinical PracticeTreatment OutcomeOncologyLiver Neoplasmeal-world dataHepatocellular carcinomaadverse event managementRetreatmentDisease Progressiondose modificationHumanmedicine.drugPhenylurea CompoundNiacinamideSorafenibmedicine.medical_specialtyCarcinoma HepatocellularDisease ResponsePrognosielderly hepatocellular carcinomaProtein Kinase InhibitorAntineoplastic AgentsmRECISTelderlymRECISTAdverse event management Child–Pugh B dose modification elderly hepatocellular carcinoma mRECIST postprogression treatment real-world data response assessment sorafenibmedicineChild–Pugh BHumansCombined Modality TherapyIntensive care medicineAdverse effectProtein Kinase InhibitorsDose Modificationreal-world databusiness.industryPhenylurea Compoundsmedicine.diseaseDiscontinuationSurgeryreal-world dataresponse assessmentsorafenibbusinessdescription
ABSTRACT Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2015-01-01 | Future Oncology |