title: Cyproheptadine significantly improves the overall and progression-free survival of sorafenib-treated advanced HCC patients.
abstract: OBJECTIVE
  Sorafenib is a recommended treatment for advanced hepatocellular carcinoma. The study is to evaluate the efficacy of sorafenib plus cyproheptadine compared with sorafenib alone in patients with advanced hepatocellular carcinoma.
  
  
  METHODS
  A retrospective cohort study reviewed all consecutive advanced hepatocellular carcinoma cases with Child-Pugh Class A disease starting sorafenib treatment at our hospital from August 2012 to March 2013. They were followed up until 31 December 2013. A total of 52 patients were enrolled: 32 patients in the combination (sorafenib-cyproheptadine) group and 20 patients in the control (sorafenib alone) group. The response to treatment, overall survival and progression-free survival were compared.
  
  
  RESULTS
  The median overall survival was 11.0 months (95% confidence interval: 6.8-15.1 months) in the combination group compared with 4.8 months (95% confidence interval: 3.1-6.6 months) in the control group (crude hazard ratio = 0.45, 95% confidence interval: 0.22-0.82). The median progression-free survival time was 7.5 months (95% confidence interval: 5.1-10.0 months) in the combination group compared with 1.7 months (95% confidence interval: 1.4-2.1 months) in the control group (crude hazard ratio = 0.43, 95% confidence interval: 0.22-0.86). Kaplan-Meier survival analysis revealed that both overall survival and progression-free survival in the combination group were significantly longer than that in the control group. The multivariate model found patients in the combination group were 76% less likely to die (adjusted hazard ratio = 0.24, 95% confidence interval: 0.10-0.58) and 82% less likely to have progression (adjusted hazard ratio = 0.18, 95% confidence interval: 0.08-0.44) during the 17 months of follow-up.
  
  
  CONCLUSIONS
  Cyproheptadine may significantly improve survival outcomes of sorafenib-treated advanced hepatocellular carcinoma patients.
authors: Department of Gastroenterology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.
authors: Yu-Min
authors: YM
authors: Feng
authors: Department of Biological Science, National Sun Yat-sen University, Kaohsiung.
authors: Chin-Wen
authors: CW
authors: Feng
authors: Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.
authors: Chin-Li
authors: CL
authors: Lu
authors: Department of Oncology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.
authors: Ming-Yang
authors: MY
authors: Lee
authors: Department of Gastroenterology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi.
authors: Chi-Yi
authors: CY
authors: Chen
authors: Department of Medical Research, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi Department of Pediatrics, School of Medicine, Taipei Medical University, Taipei, Taiwan solomon.ccc@gmail.com.
authors: Solomon Chih-Cheng
authors: SC
authors: Chen
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000401:mortality; D016022:Case-Control Studies; D003533:Cyproheptadine / Q000008:administration & dosage; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000008:administration & dosage / Q000031:analogs & derivatives; D010671:Phenylurea Compounds / Q000008:administration & dosage; D012189:Retrospective Studies; D000077157:Sorafenib
chemical_list: D010671:Phenylurea Compounds; D009536:Niacinamide; D003533:Cyproheptadine; D000077157:Sorafenib
keywords: cyproheptadine; hepatocellular carcinoma; sorafenib; survival
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