Sorafenib and Metronomic Capecitabine in Child-Pugh B patients with advanced HCC: A real-life comparison with best supportive care

被引：4

作者：

Stefanini, Benedetta ^{[1
]}

Bucci, Laura ^{[1
]}

Santi, Valentina ^{[1
]}

Reggidori, Nicola ^{[1
]}

Lani, Lorenzo ^{[1
]}

Granito, Alessandro ^{[2
]}

Pelizzaro, Filippo ^{[3
]}

Cabibbo, Giuseppe ^{[4
]}

Di Marco, Mariella ^{[5
]}

Ghittoni, Giorgia ^{[6
]}

Campani, Claudia ^{[7
]}

Svegliati-Baroni, Gianluca ^{[8
]}

Foschi, Francesco Giuseppe ^{[9
]}

Giannini, Edoardo G. ^{[10
,11
]}

Biasini, Elisabetta ^{[12
]}

Saitta, Carlo ^{[13
]}

Magalotti, Donatella ^{[14
]}

Sangiovanni, Angelo ^{[15
,16
]}

Guarino, Maria ^{[17
]}

Gasbarrini, Antonio ^{[18
]}

Rapaccini, Gian Ludovico ^{[19
]}

Masotto, Alberto ^{[20
]}

Sacco, Rodolfo ^{[21
]}

Vidili, Gianpaolo ^{[22
]}

Mega, Andrea ^{[23
]}

Azzaroli, Francesco ^{[24
]}

Nardone, Gerardo ^{[25
]}

Brandi, Giovanni ^{[26
]}

Sabbioni, Simone ^{[26
]}

Vitale, Alessandro ^{[3
]}

Trevisani, Franco ^{[1
]}

机构：

[1] IRCCS Azienda Osped Univ Bologna, Unit Semeiot Liver & Alcohol Related Dis, Bologna, Italy

[2] IRCCS Azienda Osped Univ Bologna, Div Internal Med Hepatobiliary & Immunoallerg Dis, Bologna, Italy

[3] Univ Padua, Dept Surg Oncol & Gastroenterol, Gastroenterol Unit, Padua, Italy

[4] Univ Palermo, Dept Hlth Promot Mother & Child Care Internal Med, PROMISE, Gastroenterol & Hepatol Unit, Palermo, Italy

[5] Bolognini Hosp, Med Unit, Seriate, Italy

[6] BelColle Hosp, Gastroenterol Unit, Viterbo, Italy

[7] Univ Florence, Dept Expt & Clin Med, Internal Med & Hepatol Unit, Florence, Italy

[8] Polytech Univ Marche, Gastroenterol Unit, Ancona, Italy

[9] Osped Infermi Faenza, Dept Internal Med, Faenza, Italy

[10] Univ Genoa, Dept Internal Med, Gastroenterol Unit, Genoa, Italy

[11] IRCCS Osped Policlin San Martino, Gastroenterol Unit, Genoa, Italy

[12] Azienda Osped Univ Parma, Infect Dis & Hepatol Unit, Parma, Italy

[13] Univ Messina, Dept Clin & Expt Med, Clin & Mol Hepatol Unit, Messina, Italy

[14] IRCCS Azienda Osped Univ Bologna, Div Internal Med Neurovasc & Hepatometab Dis, Bologna, Italy

[15] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Div Gastroenterol & Hepatol, Milan, Italy

[16] CRC AM & A Migliavacca Ctr Liver Dis, Milan, Italy

[17] Univ Naples Federico II, Dept Clin Med & Surg, Dis Liver & Biliary Syst Unit, Naples, Italy

[18] Rome Univ Cattolica Sacro Cuore, Fdn Policlin Univ Agostino Gemelli, Internal Med & Gastroenterol, IRCCS, Rome, Rome, Italy

[19] IRCCS San Raffaele Cassino, Rome, Italy

[20] Osped Sacro Cuore Don Calabria, Gastroenterol Unit, Negrar, Italy

[21] Foggia Univ Hosp, Gastroenterol & Digest Endoscopy Unit, Foggia, Italy

[22] Univ Sassari, Dept Med Surg & Expt Sci, Clin Med Unit, Azienda Osped Univ Sassari, Sassari, Italy

[23] Bolzano Reg Hosp, Gastroenterol Unit, Bolzano, Italy

[24] IRCCS Azienda Osped Univ Bologna, Gastroenterol Unit, Bologna, Italy

[25] Univ Naples Federico II, Dept Clin Med & Surg, Hepatogastroenterol Unit, Naples, Italy

[26] IRCCS Azienda Osped Univ Bologna, Unit Med Oncol, Bologna, Italy

来源：

DIGESTIVE AND LIVER DISEASE | 2024年 / 56卷 / 09期

关键词：

Hepatocellular carcinoma; Child-Pugh B; Sorafenib; Metronomic capecitabine; HEPATOCELLULAR-CARCINOMA; 2ND-LINE TREATMENT; PHASE-3; TRIAL; DYSFUNCTION;

D O I：

10.1016/j.dld.2024.01.199

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and Aims: The efficacy of systemic therapy for unresectable advanced hepatocellular carcinoma (aHCC) has not been proven in patients with Child-Pugh (C-P) B cirrhosis. Nevertheless, in real-world these patients are treated both with tyrosine kinase inhibitors (TKIs) and with metronomic capecitabine (MC). This study aimed to compare sorafenib and MC outcomes versus best supportive care (BSC) in C-P B patients. Method: Between 2008 and 2020, among 774 C-P B patients with aHCC not amenable/responsive to locoregional treatments, 410 underwent sorafenib, 62 MC, and 302 BSC. The propensity score matching method was used to correct the baseline unbalanced prognostic factors. Results: In the unmatched population, median OS was 9.7 months in patients treated with sorafenib, 8.0 with MC, and 3.9 months with BSC. In sorafenib vs. BSC-matched patients (135 couples), median OS was 7.3 (4.9-9.6) vs. 3.9 (2.6-5.2) months ( p < 0.001). ECOG-Performance Status, tumor size, macrovascular invasion, AFP, treatment-naive, and sorafenib were independent predictors of survival. In MC vs. BSCmatched patients (40 couples), median OS was 9.0 (0.2-17.8) vs.3.0 (2.2-3.8) months ( p < 0.001). Median OS did not differ ( p = 0.283) in sorafenib vs. MC-matched patients (55 couples). Conclusion: C-P B patients with aHCC undergoing BSC have poor survival. Both Sorafenib and MC treatment improve their prognosis. (c) 2024 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

引用

页码：1582 / 1591

页数：10

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