title: Safety and Efficacy of Sorafenib in Patients with Hepatocellular Carcinoma (HCC) and Child-Pugh A versus B Cirrhosis.
abstract: BACKGROUND
  We performed a retrospective analysis of data from a phase II study evaluating sorafenib in patients with advanced hepatocellular carcinoma (HCC) to assess differences in safety and efficacy based on Child-Pugh (CP) status (A/B).
  
  
  METHODS
  Patients received sorafenib 400 mg PO bid. We analyzed safety, pharmacokinetic (PK), and efficacy data in the two CP groups.
  
  
  RESULTS
  Ninety-eight patients were CP A; 38 were CP B, with a median duration of therapy of 4 and 1.8 months, respectively. Grade 3/4 adverse events in the CP A and B groups, respectively, included hyperbilirubinemia (14% and 53%), ascites (3% and 5%), and encephalopathy (3% and 13%). Median overall survival (OS) in the CP A group was 9.5 months, compared with 3.2 months in the CP B population. Responses were limited in both groups. AUC and C(max) values were comparable between the two groups.
  
  
  CONCLUSIONS
  Due to the lack of randomization against placebo or no therapy in this study, it is unclear if the more frequent worsening of liver cirrhosis and outcome of CP B patients are drug related or due to disease progression, or both. As expected, outcome was poorer in patients with CP B than in those with CP A cirrhosis. The hyperbilirubinemia seen in both groups may be at least partly related to inhibition of UGT1A1 by sorafenib. PK profiles were similar in the two groups. More data are needed to confirm and more fully understand the safety and efficacy of sorafenib in patients with advanced HCC and CP B cirrhosis.
authors.forename: Ghassan K
authors.initials: GK
authors.lastname: Abou-Alfa
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
authors.forename: Arie
authors.initials: A
authors.lastname: Figer
authors.forename: Jacques
authors.initials: J
authors.lastname: De Greve
authors.forename: Chetan
authors.initials: C
authors.lastname: Lathia
authors.forename: Dimitris
authors.initials: D
authors.lastname: Voliotis
authors.forename: Sibyl
authors.initials: S
authors.lastname: Anderson
authors.forename: Marius
authors.initials: M
authors.lastname: Moscovici
authors.forename: Sergio
authors.initials: S
authors.lastname: Ricci