First interim analysis of the GIDEON (Global Investigation of therapeutic decisions in hepatocellular carcinoma and of its treatment with sorafeNib) non-interventional study.
OBJECTIVE
Global Investigation of therapeutic DEcisions in hepatocellular carcinoma and Of its treatment with sorafeNib (GIDEON), a global, non-interventional, surveillance study, aims to evaluate the safety of sorafenib in all patients with unresectable hepatocellular carcinoma (uHCC) under real-life practice conditions, particularly Child-Pugh B patients, who were not well represented in clinical trials.


METHODS
Treatment decisions are determined by each physician according to local prescribing guidelines and clinical practice. Patients with uHCC who are candidates for systemic therapy, and for whom a decision has been made to treat with sorafenib, are eligible for inclusion. Demographic data and medical and disease history are recorded at entry. Sorafenib dosing and adverse events (AEs) are collected throughout the study.


RESULTS
From January 2009 to April 2011, >3000 patients from 39 countries were enrolled. The prespecified first interim analysis was conducted when the initial approximately 500 treated patients had been followed up for ≥4 months; 479 were valid for safety evaluation. Preplanned subgroup analyses indicate differences in patient characteristics, disease aetiology and previous treatments by region. Variation in sorafenib dosing by specialty are also observed; Child-Pugh status did not appear to influence the starting dose of sorafenib. The type and incidence of AEs was consistent with findings from previous clinical studies. AE profiles were comparable between Child-Pugh subgroups.


CONCLUSIONS
The GIDEON study is generating a large, robust database from a broad population of patients with uHCC. First interim analyses have shown global and regional differences in patient characteristics, disease aetiology and practice patterns. Subsequent planned analyses will allow further evaluation of early trends.
Division of Diagnostic Imaging and Intervention, Pisa University Hospital and School of Medicine, Pisa, Italy. riccardo.lencioni@med.unipi.it
R
R
Lencioni
M
M
Kudo
S-L
SL
Ye
J-P
JP
Bronowicki
X-P
XP
Chen
L
L
Dagher
J
J
Furuse
J F
JF
Geschwind
L
L
Ladrón de Guevara
L L
LL
de Guevara
C
C
Papandreou
A J
AJ
Sanyal
T
T
Takayama
S K
SK
Yoon
K
K
Nakajima
F
F
Cihon
S
S
Heldner
J A
JA
Marrero
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001557:Benzenesulfonates / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy*; D003657:Decision Making; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy*; D008297:Male; D015337:Multicenter Studies as Topic; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011364:Professional Practice; D011725:Pyridines / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012111:Residence Characteristics; D000077157:Sorafenib; D013038:Specialization / Q000706:statistics & numerical data
D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib