Journal
HEPATOLOGY RESEARCH
Volume 45, Issue 3, Pages 279-287Publisher
WILEY
DOI: 10.1111/hepr.12354
Keywords
adverse drug reaction; age; dose; hepatocellular carcinoma; propensity score; sorafenib
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Funding
- Yokohama City University
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AimPatients with hepatocellular carcinoma (HCC) who receive an initial full dose of sorafenib (800mg/day) often require a decreased dose (400mg/day) or discontinuation of therapy because of severe adverse events. We conducted a retrospective analysis of patients with HCC to compare the safety and efficacy of full- to half-dose sorafenib. MethodsWe reviewed the medical records of 218 consecutive patients with intermediate or advanced stage HCC who received half (n=73) or full-dose sorafenib (n=145) between 2009 and 2012 at four institutions. A propensity score-matching analysis was used to adjust for potential bias. ResultsMultivariate logistic regression analysis showed that increased age was an independent factor for the selection of initial half-dose sorafenib (odds ratio, 1.10; 95% confidence interval, 1.05-1.15; P<0.001). Fifty-eight patients each in the half-dose and full-dose groups were selected for propensity score matching. The incidence of grade 3-4 severe adverse effects was lower in the half-dose group (47.4% vs 66.7%, P=0.037). In contrast, the median progression-free survival (PFS) and overall survival (OS) rates were not significantly different (half-dose group, 3.8 and 10.2 months; full-dose group, 2.5 and 8.8 months; P=0.143 and 0.911, respectively). ConclusionPropensity score-matched analyses indicate that initial half-dose sorafenib treatment led to fewer severe adverse effects and a comparable survival benefit compared with a full dose in select patients with HCC, particularly for those of advanced age.
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