Chow PKH, Poon DYH, Khin MW, Singh H, Han HS, Goh ASW, Choo SP, Lai HK, Lo RHG, Tay KH, Lim TG, Gandhi M, Tan SB, Soo KC. Multicenter phase II study of sequential radioembolization-sorafenib therapy for inoperable hepatocellular carcinoma.
PLoS One 2014;
9:e90909. [PMID:
24614178 PMCID:
PMC3948695 DOI:
10.1371/journal.pone.0090909]
[Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/02/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND
The safety and tolerability of sequential radioembolization-sorafenib therapy is unknown. An open-label, single arm, investigator-initiated Phase II study (NCT0071279) was conducted at four Asia-Pacific centers to evaluate the safety and efficacy of sequential radioembolization-sorafenib in patients with hepatocellular carcinoma (HCC) not amenable to curative therapies.
METHODS
Sorafenib (400 mg twice-daily) was initiated 14 days post-radioembolization with yttrium-90 (90Y) resin microspheres given as a single procedure. The primary endpoints were safety and tolerability and best overall response rate (ORR) using RECIST v1.0.Secondary endpoints included: disease control rate (complete [CR] plus partial responses [PR] and stable disease [SD]) and overall survival (OS).
RESULTS
Twenty-nine patients with Barcelona Clinic Liver Cancer (BCLC) stage B (38%) or C (62%) HCC received a median of 3.0 GBq (interquartile range, 1.0) 90Y-microspheres followed by sorafenib (median dose/day, 600.0 mg; median duration, 4.1 months). Twenty eight patients experienced ≥1 toxicity; 15 (52%) grade ≥3. Best ORR was 25%, including 2 (7%) CR and 5 (18%) PR, and 15 (54%) SD. Disease control was 100% and 65% in BCLC stage B and C, respectively. Two patients (7%) had sufficient response to enable radical therapy. Median survivals for BCLC stage B and C were 20.3 and 8.6 months, respectively.
CONCLUSIONS
This study shows the potential efficacy and manageable toxicity of sequential radioembolization-sorafenib.
TRIAL REGISTRATION
ClinicalTrials.gov NCT00712790.
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