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Predicting Treatment Response to Image-Guided Therapies Using Machine Learning: An Example for Trans-Arterial Treatment of Hepatocellular Carcinoma
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Differential Response to Sorafenib Administration for Advanced Hepatocellular Carcinoma

Song-Fong Huang1, Sio-Wai Chong1, Chun-Wei Huang1

  • 1Department of Surgery, New Taipei Municipal Tucheng Hospital, New Taipei City 23652, Taiwan.

Biomedicines
|September 23, 2022
PubMed

Insights

Sorafenib shows variable response in advanced hepatocellular carcinoma (aHCC) target lesions. Macroscopic venous thrombus, bone metastases, and high AFP indicate poor outcomes, suggesting ALBI grade and lesion burden guide treatment selection.

Area of Science:

  • Hepatobiliary Cancers
  • Medical Oncology
  • Pharmacological Response

Background:

  • Sorafenib is a standard treatment for advanced hepatocellular carcinoma (aHCC).
  • Limited data exists on the differential response of various target lesions to sorafenib.
  • Understanding treatment response variations is crucial for optimizing aHCC management.

Purpose of the Study:

  • To evaluate the treatment response of diverse target lesions in patients with advanced hepatocellular carcinoma (aHCC) receiving sorafenib.
  • To identify factors influencing sorafenib efficacy and patient outcomes in aHCC.

Main Methods:

  • Retrospective analysis of 377 advanced hepatocellular carcinoma (aHCC) patients treated with sorafenib.
  • Assessment of treatment response (complete/partial response, stable disease, progressive disease) within the first six months.
  • Analysis of metastatic lesion distribution (liver, bone, lung, thrombus, lymph nodes, peritoneum) and correlation with outcomes.

Main Results:

  • Overall response rates to sorafenib were 19.3% complete/partial response, 35.4% stable disease, and 45.2% progressive disease within six months.
  • Metastatic sites included liver (39.4%), lung (32.5%), portal/hepatic vein thrombus (25.9%), and bone (12.7%).
  • Poor outcomes were associated with macroscopic venous thrombus, bone metastases, elevated alpha-fetoprotein (AFP), and multiple target lesions. ALBI grade A correlated with better outcomes.

Conclusions:

  • Sorafenib demonstrates variable efficacy across different target lesions in advanced hepatocellular carcinoma (aHCC).
  • Patients with venous thrombus or multiple metastases may benefit from considering sorafenib as a second-line treatment option.
  • The Albumin-Bilirubin (ALBI) liver function grading system should be incorporated as a criterion for guiding sorafenib treatment decisions in aHCC.
Keywords:
ALBIadvanced HCCsorafenibtarget lesions

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