Early decrease in α-fetoprotein, but not des-γ-carboxy prothrombin, predicts sorafenib efficacy in patients with...

Area of Science:

• Hepatocellular Carcinoma Research
• Medical Oncology
• Biomarker Discovery

Background:

• Advanced hepatocellular carcinoma (HCC) presents a significant therapeutic challenge.
• Sorafenib is a targeted therapy used for advanced HCC.
• Predicting early treatment response is crucial for patient management.

Purpose of the Study:

• To investigate the relationship between early changes in alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels and antitumor response to sorafenib in advanced HCC.
• To determine if AFP and DCP can serve as early predictive markers for sorafenib efficacy.

Main Methods:

• Forty-eight patients with advanced HCC were enrolled.
• AFP and DCP levels were measured at baseline, 2 weeks, and 4 weeks after initiating sorafenib.
• Antitumor response was assessed using RECIST criteria at 4 weeks, categorizing patients into partial response (PR) + stable disease (SD) or progressive disease (PD) groups.

Main Results:

• Significantly lower AFP ratios were observed in the PR + SD group compared to the PD group at both 2 and 4 weeks (p = 0.002).
• DCP levels were elevated in both the PR + SD and PD groups at 2 and 4 weeks.
• Early AFP ratio changes showed a significant correlation with treatment response.

Conclusions:

• Early evaluation of AFP ratios at 2 and 4 weeks after sorafenib initiation may predict antitumor response in advanced HCC.
• Early elevation of DCP does not necessarily indicate treatment failure and can occur even with therapeutic efficacy.