Sorafenib therapy in advanced hepatocellular carcinoma: the SHARP trial

2009 ◽  
Vol 9 (6) ◽  
pp. 739-745 ◽  
Author(s):  
Lorenza Rimassa ◽  
Armando Santoro
2021 ◽  
pp. 224-231
Author(s):  
Richard T. Lee ◽  
Peiying Yang ◽  
Asrar Alahmadi ◽  
Jennifer McQuade ◽  
Eric Yuan ◽  
...  

Background: Hepatocellular carcinoma (HCC) is the fourth leading cause of death from cancer worldwide, and for advanced HCC the prognosis is poor. Preliminary studies indicate mistletoe extracts may have anticancer activity for HCC. Methods: A prospective observational case series of advanced HCC patients that chose to take a mistletoe extract called viscum fraxini-2 (VF-2) alone for treatment. Time on treatment, imaging, and laboratory values were collected for descriptive analyses. Results: A total of 12 patients with advanced HCC enrolled onto the protocol, and 10 patients had data available for evaluation. The majority were male (10/12) with a median age of 64 (SD 11). Most patients had received sorafenib therapy (9/12) and had varying Child-Pugh classes (A-4, B-6, C-2). Treatment with VF-2 ranged from 1 to 36 weeks with a mean of 12.3 weeks (SD 12). Six patients received 8 weeks of treatment, and 3 patients received 12 or more weeks of treatment. For patients that received at least 4 weeks of treatment, the average AFP value stabilized during the first 4 weeks of treatment. Two patients experienced an AFP decrease of >30%, approximately 37 and 40% decreases at the nadir. One patient had stable disease of 9 months. Major side effects were fever, fatigue, rash, and local injection site reaction of swelling, redness, and tenderness. Conclusion: This case series of advanced HCC indicates that mistletoe extract VF-2 may have potential biological activity against HCC for selected patients. Research is needed to identify the active compound and predictive markers of response.


Author(s):  
Ana Plano S�nchez ◽  
Luc�a Velasco Roces ◽  
Isabel Zapico Garc�a ◽  
Eva L�zaro L�pez ◽  
Miguel Calleja Hernandez ◽  
...  

2020 ◽  
Vol 32 (10) ◽  
pp. 1407-1408
Author(s):  
Elizabeth S. Aby ◽  
Amir Sultan ◽  
Abate Bane ◽  
Zerihun Wondifraw ◽  
Jose D. Debes

2014 ◽  
Vol 62 (11) ◽  
pp. 2204-2205 ◽  
Author(s):  
Edoardo Francini ◽  
Silvia Mazzaroppi ◽  
Anna I. Fiaschi ◽  
Roberto Petrioli ◽  
Letizia Laera ◽  
...  

2017 ◽  
Vol 14 (4) ◽  
pp. 4853-4856 ◽  
Author(s):  
Jung Gil Park ◽  
Won Young Tak ◽  
Soo Young Park ◽  
Young Oh Kweon ◽  
Se Young Jang ◽  
...  

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Rogério Camargo-Pinheiro-Alves ◽  
Daniele E. Viera-Alves ◽  
Arthur Malzyner ◽  
Otavio Gampel ◽  
Thaisa de F. Almeida-Costa ◽  
...  

Introduction and aim. Sorafenib has been the standard of care for first-line treatment of advanced hepatocellular carcinoma, a complex disease that affects an extremely heterogenous population. Thereby requiring multidisciplinary individualized treatment strategies that match the disease characteristics and the patients’ specific needs. Material and methods. Data for 175 patients who received sorafenib for hepatocellular carcinoma in three different hospitals in Sao Paulo, Brazil over a span of nine years were retrospectively analyzed. Results. The median age was 62 years. Percentages of patients with Child-Pugh A, B and C liver cirrhosis were 61%, 31% and 5%, respectively. Approximately half of the patients had Barcelona Clinic Liver Cancer stage B disease, and the other half had stage C. The median treatment duration was 253 days. Sorafenib dose was reduced to 400 mg/day in 41% of the patients due to toxicity. Overall objective response rate as per Response Evaluation Criteria in Solid Tumors and its modified version was 39%. Patients who received transarterial chemoembolization (TACE) at any point during sorafenib therapy were significantly more likely to experience an objective response. After a median follow-up of 339 days, the median overall survival was 380 days. Child-Pugh cirrhosis, tumor response and concomitant chemoembolization were independent prognostic factors for overall survival in multivariate analysis. Conclusion. Our results suggest that, in experienced hands, sorafenib therapy may benefit carefully selected hepatocellular carcinoma patients for whom other therapies are initially contraindicated, including those patients with Child-Pugh B liver function and those patients who are subsequently treated with concomitant TACE.


2016 ◽  
Vol 2 (8) ◽  
pp. 224 ◽  
Author(s):  
Alit Abraham ◽  
Charumathi Purushothaman ◽  
Dhanya Damien ◽  
Jackson James ◽  
Prudence Attilade Rodrigues ◽  
...  

Kanzo ◽  
2010 ◽  
Vol 51 (7) ◽  
pp. 403-404 ◽  
Author(s):  
Teiji Kuzuya ◽  
Kaoru Tsuchiya ◽  
Keisuke Tanaka ◽  
Yuichiro Suzuki ◽  
Takahide Hoshioka ◽  
...  

2012 ◽  
Vol 63 (2) ◽  
pp. 159-169 ◽  
Author(s):  
Yongping Yang ◽  
Yinying Lu ◽  
Chunping Wang ◽  
Wenlin Bai ◽  
Jianhui Qu ◽  
...  

Author(s):  
Robert J Cersosimo

Abstract Purpose The activity of targeted agents and immunotherapy in the management of advanced hepatocellular carcinoma (HCC) is reviewed. Summary The first drug approved by the Food and Drug Administration for advanced HCC, sorafenib, was approved in 2007. Regorafenib, the second drug, was approved 10 years later. Six additional drugs have been approved since. Targeted agents and checkpoint inhibitors are the only agents approved for systemic therapy of advanced HCC. Sorafenib and lenvatinib are approved as first-line agents, with regorafenib, cabozantinib, ramucirumab, nivolumab (used alone or with ipilimumab), and pembrolizumab approved for patients who have received prior sorafenib therapy. Most patients in phase 3 studies had Child-Pugh class A cirrhosis, and data on the use of these agents in patients with more advanced hepatic dysfunction are limited. All of the targeted agents improve survival in patients with advanced disease. Median overall survival durations of up to 12.3 and 13.6 months were reported with use of sorafenib and lenvatinib, respectively, in phase 3 trials. Overall survival durations of 10.6, 10.2, and 9.2 months have been achieved with use of regorafenib, cabozantinib, and ramucirumab as second-line therapy after sorafenib. A median overall survival of 13.2 months was reported in 1 cohort of a dose-expansion study of nivolumab in which all patients received prior sorafenib therapy. Median survival durations of 12.9 months and 13.9 months were reported with use of pembrolizumab in patients with a history of sorafenib therapy. The most common adverse effects associated with targeted agents are dermatological effects, diarrhea, fatigue, and hypertension. Immune-mediated adverse effects are associated with checkpoint inhibitors. Conclusion Targeted agents and checkpoint inhibitors are the standard of therapy for patients who need systemic therapy for advanced HCC.


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