Correlation of skin toxicity and hypertension with clinical benefit in advanced hepatocellular carcinoma patients treated with sorafenib.
OBJECTIVE
The purpose of this study was to identify the correlation of skin toxicity and hypertension with clinical benefit in advanced hepatocellular carcinoma (HCC) patients treated with sorafenib by analyzing medical records retrospectively.


METHODS
Data from medical records was statistically analyzed to identify a correlation of skin toxicity and hypertension with treatment response and prognosis in advanced HCC patients who had received sorafenib at the Asan Medical Center from July 2010 to June 2012. This study investigated prognostic factors for overall survival and the correlation between the development of skin toxicities and hypertension.


RESULTS
A total of 99 patients receiving sorafenib were included in this study. 29 patients who developed skin toxicities Grade 2 or higher showed significantly longer survival than the 70 patients who developed skin toxicities less than Grade 2 or those without skin toxicity (p = 0.024). However, development of hypertension was not related to survival (p = 0.262). In a multivariate analysis, skin toxicities were found to be good prognostic factors for overall survival (hazard ratio, 0.320; 95% CI, 0.119 - 0.861; p = 0.024) as well as low α-fetoprotein level (hazard ratio, 0.195; 95% CI, 0.076 - 0.500; p = 0.001). On the other hand, no correlation was found between the development of skin toxicities and hypertension (p = 0.109).


CONCLUSIONS
Skin toxicities that are common adverse reactions in advanced HCC patients treated with sorafenib may be used as surrogate markers for clinical benefit. Therefore, early detection and proper management of these toxicities is crucial for continuing treatment with sorafenib.
Sun Young
SY
Shin
Yu Jeung
YJ
Lee
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced*; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000009:adverse effects*; D011379:Prognosis; D040262:Receptors, Vascular Endothelial Growth Factor / Q000037:antagonists & inhibitors*; D012867:Skin / Q000187:drug effects*; D000077157:Sorafenib
D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib; D040262:Receptors, Vascular Endothelial Growth Factor