Efficacy and Safety of Sorafenib in a Racially Diverse Patient Population with Advanced Hepatocellular Carcinoma

Anticancer Res. 2018 Jul;38(7):4027-4034. doi: 10.21873/anticanres.12691.

Abstract

Background: There are few efficacy and toxicity data on sorafenib for patients treated for hepatocellular carcinoma (HCC) who are not Caucasian or Asian.

Materials and methods: A retrospective analysis was carried out on 67 patients treated with sorafenib for advanced HCC at an urban referral center. Patients were categorized by race, age, sex, status, stage, and dose. Primary outcomes were time to progression (TTP), toxicity, and treatment discontinuation by race.

Results: African-Americans and Caucasians had significantly shorter TTP than patients of other races (Hispanic, Asian, and unidentified) [African-Americans: hazard ratio (HR)=5.01, p=0.0068; Caucasians: HR=8.25, p=0.0008). There were no significant differences in time to toxicity (p=0.99). Caucasians had the shortest time to therapy discontinuation (p=0.0298). TTP was shorter for males (HR=3.51, p=0.028), and longer for patients experiencing toxicity (HR=0.47, p=0.046).

Conclusion: Among patients treated with sorafenib for advanced HCC, non African-American/non-Caucasian race, female sex, and toxicity were associated with significantly longer time to progression.

Keywords: Sorafenib; advanced-stage hepatocellular carcinoma; disparities; race; time to progression.

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / ethnology
  • Disease Progression
  • Female
  • Humans
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / ethnology
  • Male
  • Middle Aged
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives*
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / adverse effects
  • Phenylurea Compounds / therapeutic use*
  • Population Groups
  • Retrospective Studies
  • Sorafenib
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Phenylurea Compounds
  • Niacinamide
  • Sorafenib