Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma
IntroductionThe first-line treatment for advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab, but its availability is not universal and elderly patients are underrepresented in clinical trials. There is little evidence of efficacy and tolerability in elderly patients under syste...
| Authors: | ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Status: | Published version |
| Publication date: | 2022 |
| Country: | España |
| Institution: | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| Repository: | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| OAI Identifier: | oai:i3pt.fundanetsuite.com:p1267 |
| Online Access: | https://i3pt.portalinvestigacion.com/publicaciones/1267 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136164872&doi=10.3389%2ffonc.2022.829483&partnerID=40&md5=44ea15397266d82f8e75fa6f7b08372a |
| Access Level: | Open access |
| Keyword: | sorafenib elderly patients hepatocellular carcinoma overall survival safety outcome |
| _version_ | 1878735430774423552 |
|---|---|
| author | Soria, A |
| author2 | Calvo, M Casas, M Vidales, Z Munoz-Martinez, S Sapena, V Puigvehi, M Canillas, L Guardeno, R Gallego, A Minguez, B Horta, D Clos, A Montoliu, S Roget, M Reig, M Vergara, M |
| author2_role | author author author author author author author author author author author author author author author author |
| author_browse | Calvo, M Canillas, L Casas, M Clos, A Gallego, A Guardeno, R Horta, D Minguez, B Montoliu, S Munoz-Martinez, S Puigvehi, M Reig, M Roget, M Sapena, V Soria, A Vergara, M Vidales, Z |
| author_facet | Soria, A Calvo, M Casas, M Vidales, Z Munoz-Martinez, S Sapena, V Puigvehi, M Canillas, L Guardeno, R Gallego, A Minguez, B Horta, D Clos, A Montoliu, S Roget, M Reig, M Vergara, M |
| author_role | author |
| collection | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| description | IntroductionThe first-line treatment for advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab, but its availability is not universal and elderly patients are underrepresented in clinical trials. There is little evidence of efficacy and tolerability in elderly patients under systemic treatment. The aims of this study were to characterize the profile of elderly patients treated with sorafenib, assess their survival and safety profile in order to extrapolate their eligibility for systemic treatment. MethodsRetrospective multicentre study of HCC patients aged >= 75 years old treated with sorafenib from January 2008 to December 2019. Demographic data, baseline characteristics, and variables related to HCC and sorafenib were recorded. Overall survival (OS) and safety were analyzed. ResultsThe study included 206 patients from 11 hospitals, median age 77.9 years; 71.4% men and 62.6% stage Barcelona Clinic Liver Cancer- C (BCLC-C). The main causes of cirrhosis were hepatitis C (60.7%) and alcohol (14.7%). Most patients (84.5%) started with sorafenib 800mg and 15.5% at lower dosage. Arterial hypertension (AHT) (74.2 vs 62.2%; standardized mean differences (STD): 26) and baseline ECOG-PS>0 (45.3 vs 34.7%; STD: 38.2) differed significantly between patients receiving low and full doses. Median OS was 15.4 months (18.2 in BCLC-B vs 13.6 in BCLC-C). OS was not modified by comorbidities, age or period with more expertise. ConclusionsSorafenib appears to be safe in elderly patients with HCC. This is the first study to characterize the profile of elderly patients to be considered for systemic treatment. These findings could be used as the reference profile for elderly candidates for atezolizumab-bevacizumab. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_7c8df8fdf2ec54df4e736338c587b4ac |
| institution | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| instname_str | Institut d'Investigació i Innovació Parc Taulí (I3PT) |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:i3pt.fundanetsuite.com:p1267 |
| publishDate | 2022 |
| publishDateSort | 2022 |
| publisher | FRONTIERS MEDIA SA |
| publisherStr | FRONTIERS MEDIA SA |
| reponame_str | r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí |
| spelling | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma Soria, A Calvo, M Casas, M Vidales, Z Munoz-Martinez, S Sapena, V Puigvehi, M Canillas, L Guardeno, R Gallego, A Minguez, B Horta, D Clos, A Montoliu, S Roget, M Reig, M Vergara, M sorafenib elderly patients hepatocellular carcinoma overall survival safety outcome IntroductionThe first-line treatment for advanced hepatocellular carcinoma (HCC) is atezolizumab plus bevacizumab, but its availability is not universal and elderly patients are underrepresented in clinical trials. There is little evidence of efficacy and tolerability in elderly patients under systemic treatment. The aims of this study were to characterize the profile of elderly patients treated with sorafenib, assess their survival and safety profile in order to extrapolate their eligibility for systemic treatment. MethodsRetrospective multicentre study of HCC patients aged >= 75 years old treated with sorafenib from January 2008 to December 2019. Demographic data, baseline characteristics, and variables related to HCC and sorafenib were recorded. Overall survival (OS) and safety were analyzed. ResultsThe study included 206 patients from 11 hospitals, median age 77.9 years; 71.4% men and 62.6% stage Barcelona Clinic Liver Cancer- C (BCLC-C). The main causes of cirrhosis were hepatitis C (60.7%) and alcohol (14.7%). Most patients (84.5%) started with sorafenib 800mg and 15.5% at lower dosage. Arterial hypertension (AHT) (74.2 vs 62.2%; standardized mean differences (STD): 26) and baseline ECOG-PS>0 (45.3 vs 34.7%; STD: 38.2) differed significantly between patients receiving low and full doses. Median OS was 15.4 months (18.2 in BCLC-B vs 13.6 in BCLC-C). OS was not modified by comorbidities, age or period with more expertise. ConclusionsSorafenib appears to be safe in elderly patients with HCC. This is the first study to characterize the profile of elderly patients to be considered for systemic treatment. These findings could be used as the reference profile for elderly candidates for atezolizumab-bevacizumab. FRONTIERS MEDIA SA https://i3pt.portalinvestigacion.com/publicaciones/1267 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136164872&doi=10.3389%2ffonc.2022.829483&partnerID=40&md5=44ea15397266d82f8e75fa6f7b08372a |
| spellingShingle | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma Soria, A sorafenib elderly patients hepatocellular carcinoma overall survival safety outcome |
| status_str | publishedVersion |
| title | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| title_full | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| title_fullStr | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| title_full_unstemmed | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| title_short | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| title_sort | Survival and adverse events of elderly patients treated with sorafenib for hepatocellular carcinoma |
| topic | sorafenib elderly patients hepatocellular carcinoma overall survival safety outcome |
| topic_facet | sorafenib elderly patients hepatocellular carcinoma overall survival safety outcome |
| url | https://i3pt.portalinvestigacion.com/publicaciones/1267 https://www.scopus.com/inward/record.uri?eid=2-s2.0-85136164872&doi=10.3389%2ffonc.2022.829483&partnerID=40&md5=44ea15397266d82f8e75fa6f7b08372a |