title: Efficacy of sorafenib in patients with hepatocellular carcinoma refractory to transcatheter arterial chemoembolization.
abstract: BACKGROUND
  The efficacy of sorafenib for hepatocellular carcinoma (HCC) patients refractory to transcatheter arterial chemoembolization (TACE) has not yet been clarified. We investigated the efficacy of sorafenib in HCC patients who were refractory to TACE (sorafenib group) and retrospectively compared the results with those of patients treated with hepatic arterial infusion chemotherapy using cisplatin (cisplatin group).
  
  
  METHODS
  We evaluated the anti-tumor effect, the time to progression, and the overall survival in 48 patients in the sorafenib group and 66 patients in the cisplatin group.
  
  
  RESULTS
  The disease control rate to sorafenib was 60.4 %, the median time to progression was 3.9 months, and the median survival time was 16.4 months in patients who were refractory to TACE. When compared with the cisplatin group, significant differences in the patient characteristics were not observed between the two groups with the exception of patient age; however, the disease control rate (cisplatin group 28.8 %, P = 0.001), time to progression (cisplatin group: median 2.0 months, hazard ratio 0.44, P < 0.01), and overall survival (cisplatin group: median 8.6 months, hazard ratio 0.57, P < 0.001) were significantly superior in the sorafenib group. The multivariate analysis also showed the sorafenib treatment to be the most significant factor contributing to prolongation of time to progression and overall survival.
  
  
  CONCLUSIONS
  Sorafenib showed favorable treatment results in patients refractory to TACE. When compared with hepatic arterial infusion chemotherapy using cisplatin, sorafenib demonstrated a significantly higher disease control rate, a longer time to progression and increased overall survival.
authors.affiliation: Division of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan, masikeda@east.ncc.go.jp.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ikeda
authors.forename: Shuichi
authors.initials: S
authors.lastname: Mitsunaga
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shimizu
authors.forename: Izumi
authors.initials: I
authors.lastname: Ohno
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okuyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Kuwahara
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kondo
authors.forename: Chigusa
authors.initials: C
authors.lastname: Morizane
authors.forename: Hideki
authors.initials: H
authors.lastname: Ueno
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Satake
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Arai
authors.forename: Takuji
authors.initials: T
authors.lastname: Okusaka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D016461:Chemoembolization, Therapeutic / Q000379:methods; D002945:Cisplatin / Q000627:therapeutic use*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009536:Niacinamide / Q000031:analogs & derivatives* / Q000627:therapeutic use; D010671:Phenylurea Compounds / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077157:Sorafenib; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib; D002945:Cisplatin