索拉非尼用于晚期肝细胞癌的肝移植预后比未进行肝移植的

StephenW

Sorafenib for advanced hepatocellular carcinoma provides better prognosis after liver transplantation than without liver transplantation

    Soon Kyu Lee, Jeong Won Jang, Heechul Nam, Pil Soo Sung, Hee Yeon Kim, Jung Hyun Kwon, Sung Won Lee, Do Seon Song, Chang Wook Kim, Myeong Jun Song, Ho Joong Choi, Young Kyoung You, Si Hyun Bae, Jong Young Choi & Seung Kew Yoon

Hepatology International volume 15, pages137–145(2021)Cite this article

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Abstract
Background

Although sorafenib has been used to treat advanced hepatocellular carcinoma (HCC), the efficacy of sorafenib in patients with recurrent HCCs after liver transplantation (LT) has not been compared with that in patients without LT (non-LT).
Methods

Between 2008 and 2019, a total of 832 consecutive HCC patients treated with sorafenib (790 in the non-LT group and 42 in the LT group) were enrolled. The primary outcome was overall survival (OS). Secondary outcomes were time-to-progression (TTP), objective response rate (ORR) and disease control rate (DCR). Treatment outcomes were assessed by multiple subgroup analyses and propensity-score matching (PSM).
Results

The median follow-up duration was 152.5 days. The LT group was younger and had smaller intrahepatic HCC than the non-LT group. The LT group showed significantly better OS (16.8 vs. 7.1 months, p < 0.001), TTP, ORR and DCR than the non-LT group. The superior efficacy of sorafenib in the LT group was corroborated in multiple subgroup analyses stratified by metastasis, effective sorafenib maintenance dose, or Child-Turcotte-Pugh class A. LT was identified as an independent factor for favorable OS. Intrahepatic HCC was the strongest tumor-related factor for both OS and TTP and was significantly associated with tumor response and hepatic function. Finally, subanalyses including only patients with small intrahepatic HCC or PSM modeling showed no difference in sorafenib efficacy between the LT and the non-LT groups.
Conclusion

Sorafenib provides better outcomes in the LT setting than the non-LT setting. This benefit may be associated with the smaller intrahepatic HCC coupled with preserved hepatic function in LT recipients.

StephenW

索拉非尼用于晚期肝细胞癌的肝移植预后比未进行肝移植的预后好

    很快，李圭圭，郑远章，Heechul Nam，Pil Soo Sung，熙妍金，郑贤权，宋媛媛，杜善嵩，金昌旭，明俊嵩，何钟彩，杨京佑，施贤培，钟荣彩和成邱允

国际肝病杂志第15卷，第137–145页（2021）

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抽象的
背景

尽管索拉非尼已被用于治疗晚期肝细胞癌（HCC），但索拉非尼在肝移植（LT）后复发性HCC患者中的疗效尚未与无LT（非LT）患者相比较。
方法

在2008年至2019年之间，总共入选了832名接受索拉非尼治疗的HCC患者（非LT组为790例，LT组为42例）。主要结果是总体生存期（OS）。次要结果是进展时间（TTP），客观缓解率（ORR）和疾病控制率（DCR）。通过多个亚组分析和倾向评分匹配（PSM）评估治疗结果。
结果

中位随访时间为152.5天。 LT组比非LT组年轻，肝内HCC较小。 LT组的OS，TTP，ORR和DCR显着优于非LT组（16.8比7.1个月，p <0.001）（p <0.001）。索拉非尼在LT组中的优越疗效在通过转移，有效索拉非尼维持剂量或Child-Turcotte-Pugh A级分层的多个亚组分析中得到证实。LT被确定为OS良好的独立因素。肝内HCC是OS和TTP的最强肿瘤相关因素，并且与肿瘤反应和肝功能显着相关。最后，亚分析仅包括肝内HCC或PSM模型较小的患者，LT组和非LT组之间的索拉非尼疗效无差异。
结论

索拉非尼在LT设置中比非LT设置提供更好的结果。该益处可能与较小的肝内HCC以及LT受体中保留的肝功能有关。