Elevated platelets, advanced BCLC stage tied to poor survival in sorafenib-treated HCC patients
Hepatocellular carcinoma (HCC) patients receiving sorafenib may have poor survival if they present with pretreatment elevated platelets or have advanced Barcelona Clinic Liver Cancer (BCLC) stage, a recent study has shown.
In total, 1,336 patients (median age, 65 years; interquartile range [IQR], 55–71; 70 percent male) were evaluated, of whom 127 received sorafenib and were included in the study. Median overall survival (OS) in all patients was 8 months (IQR, 2–17).
Multivariate analysis revealed that survival was associated with platelets >/<250,000 mm3 (2 vs 8 months; p=0.01) and BCLC stage (A/B, 13 vs C/D, 6 months; p=0.04). Subanalysis of patients also showed the independent association of BCLC stage C and platelets >/<250,000 mm3 with survival (2 vs 5.5 months; p=0.03)
Survival was longer if patients experienced any side effects from sorafenib use (11 vs 2 months; p=0.009). However, patients who stopped sorafenib treatment because of side effects had shorter survival than those who were able to tolerate them and continue treatment (7.5 vs 13 months; p=0.01).
This retrospective analysis sought to examine the efficacy, safety profile and variables associated with survival in HCC patients treated with sorafenib in South America. Between January 2010 and June 2017, the authors examined HCC patients who received sorafenib from eight medical centres in five South American countries.
OS, which was defined as time from sorafenib initiation to death or last follow-up, was the primary endpoint of the study. Cox proportional hazard regression and log-rank tests were used to assess the risk factors for decreased OS.