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Sorafenib for treatment of hepatocellular carcinoma: a systematic review

Bingru Xie1, David H Wang, Stuart Jon Spechler

  • 1Department of Medicine, VA North Texas Healthcare System, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA. Bingru.Xie@va.gov

Digestive Diseases and Sciences
|March 28, 2012
PubMed
Abstract

Insights

Sorafenib offers modest survival benefits for advanced liver cancer but shows poorer response in hepatitis B patients. Side effects like hand-foot syndrome are more common with advanced cirrhosis or combination therapy.

Area of Science:

  • Oncology
  • Hepatology
  • Pharmacology

Background:

  • Sorafenib inhibits kinases crucial for hepatocellular carcinoma (HCC) cell proliferation and angiogenesis.
  • It is an approved treatment for advanced HCC.

Purpose of the Study:

  • To evaluate the efficacy and safety of sorafenib in advanced HCC.
  • To identify clinical factors influencing sorafenib's effectiveness and side effect profile.

Main Methods:

  • Systematic review adhering to PRISMA guidelines.
  • Inclusion of prospective studies on sorafenib monotherapy or combination therapy for advanced HCC.

Main Results:

  • Sorafenib prolonged overall survival (OS) by 2.3-2.8 months and time to progression (TTP) by 1.4-2.7 months in placebo-controlled trials.
  • Disease control rate (DCR) increased by 11-19%.
  • Poorer outcomes (OS, DCR) observed in patients with a high percentage of hepatitis B, and increased side effects (diarrhea, fatigue, hand-foot syndrome) noted in advanced cirrhosis or with 5-FU combination therapy.

Conclusions:

  • Sorafenib provides statistically significant but clinically modest improvements in OS, TTP, and DCR.
  • Hepatitis B patients may respond less favorably to sorafenib compared to hepatitis C patients.
  • Combination therapy efficacy over sorafenib alone remains uncertain, with increased hand-foot syndrome risk in specific patient groups.

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