Alternative treatments in advanced hepatocellular carcinoma patients with progressive disease after sorafenib treatment: a prospective multicenter cohort study

// Masahito Nakano 1 , Masatoshi Tanaka 2 , Ryoko Kuromatsu 1 , Hiroaki Nagamatsu 3 , Manabu Satani 1 , Takashi Niizeki 1 , Shusuke Okamura 1 , Hideki Iwamoto 1 , Shigeo Shimose 1 , Tomotake Shirono 1 , Yu Noda 1 , Hironori Koga 1 , Takuji Torimura 1 , for the Kurume Liver Cancer Study Group of Japan 1 Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka, Japan 2 Yokokura Hospital, Miyama, Fukuoka, Japan 3 Yame General Hospital, Yame, Fukuoka, Japan Correspondence to: Masahito Nakano, email: nakano_masahito@kurume-u.ac.jp Keywords: sorafenib, hepatocellular carcinoma, progressive disease, follow-up treatments Received: February 08, 2016     Accepted: June 30, 2016     Published: July 23, 2016 ABSTRACT Sorafenib is an oral multikinase inhibitor that has been approved to treat advanced hepatocellular carcinoma (HCC), though it is unclear how much benefit advanced HCC patients with progressive disease (PD) derive from sorafenib treatment. This study aimed to assess survival risk factors and evaluate therapeutic strategies for advanced HCC patients with PD after sorafenib treatment. We analyzed the clinical data and treatment outcomes for 315 consecutive advanced HCC patients treated with sorafenib. Univariate analyses of overall survival identified therapeutic effect as an independent risk factor in all patients. Among all patients, 141 developed PD. Of those, 58 (41%) were treated with sorafenib monotherapy, 70 (50%) with agents other than sorafenib, and 13 (9%) were not treated at all. The median survival time was 6.1 months for PD patients with sorafenib monotherapy and 12.2 months for those administered alternative treatments (p u003c 0.0001). Our results indicated that sorafenib treatment may have negative long-term therapeutic effects in advanced HCC patients with PD, and that alternative treatments should be considered for these patients after sorafenib administration.