Efficacy of apatinib in patients with sorafenib–transarterial chemoembolization refractory hepatocellular carcinoma: a retrospective study,Hepatology International

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Efficacy of apatinib in patients with sorafenib–transarterial chemoembolization refractory hepatocellular carcinoma: a retrospective study
Hepatology International ( IF 5.9 ) Pub Date : 2021-08-20 , DOI: 10.1007/s12072-021-10198-3
Yanyan Cao _{1,

2} , Tao Ouyang _{1,

2} , Fu Xiong _{1,

2} , Xuefeng Kan _{1,

2} , Lei Chen _{1,

2} , Bin Liang _{1,

2} , Chuansheng Zheng _{1,

2}

Affiliation

Purpose

To investigate the efficacy of sequential apatinib treatment in patients with unresectable hepatocellular carcinoma (HCC) refractory to sorafenib–transarterial chemoembolization (TACE).

Materials and methods

This respective study was conducted on 95 consecutive patients with sorafenib–TACE-refractory unresectable HCC in our center from January 2014 to December 2019. According to the response to sorafenib–TACE treatment and the subsequent management, the eligible patients were assigned into three groups: sorafenib–TACE (ST) group, sorafenib–TACE–apatinib (STA) group, and sorafenib–TACE–supportive care (STS) group. The differences in overall survival (OS) and tumor response were compared among the three groups. Risk factors related to prognosis were analyzed.

Results

A total of 58 patients were enrolled in the study, with 11, 15, and 28 patients in ST, STA, and STS group, respectively. The median OS of the STA group was significantly improved when compared with the STS group, either from the start of sorafenib–TACE resistance or the initiation of sorafenib–TACE therapy (14.0 versus 4.0 months, p = 0.003; 19.0 versus 9.0 months, p < 0.001; respectively). Additionally, from the start of sorafenib–TACE treatment, the median OS of the STA group was longer than that of the ST group without statistical difference (19.0 versus 15.0 months, p = 0.28), so did the comparison of median OS between the ST group and the STS group (15.0 versus 9.0 months, p = 0.06). Extrahepatic metastases were an independent risk factor for poor prognosis.

Conclusion

In patients with sorafenib–TACE-refractory HCC, subsequent apatinib treatment significantly improved the OS when compared with supportive care, and produced comparative outcomes with those sorafenib–TACE responders.

中文翻译：

阿帕替尼治疗索拉非尼-经动脉化疗栓塞难治性肝细胞癌患者的疗效：一项回顾性研究

目的

研究阿帕替尼序贯治疗对索拉非尼经动脉化疗栓塞 (TACE) 难治的不可切除肝细胞癌 (HCC) 患者的疗效。

材料和方法

本研究分别针对 2014 年 1 月至 2019 年 12 月在我们中心的 95 例索拉非尼-TACE 难治性不可切除 HCC 患者进行。根据对索拉非尼-TACE 治疗的反应和后续管理，符合条件的患者分为三组：索拉非尼-TACE（ST）组、索拉非尼-TACE-阿帕替尼（STA）组和索拉非尼-TACE-支持治疗（STS）组。比较三组间总生存期（OS）和肿瘤反应的差异。分析与预后相关的危险因素。

结果

本次研究共纳入 58 名患者，其中 ST、STA 和 STS 组分别为 11、15 和 28 名患者。与 STS 组相比，无论是从索拉非尼-TACE 耐药开始还是索拉非尼-TACE 治疗开始，STA 组的中位 OS 均显着改善（14.0 个月对比 4.0 个月，p = 0.003；19.0 个月对比 9.0 个月，p < 0.001；分别）。此外，从索拉非尼-TACE 治疗开始，STA 组的中位 OS 长于 ST 组，无统计学差异（19.0 个月 vs 15.0 个月，p = 0.28），ST 组之间的中位 OS 比较也没有统计学差异。组和 STS 组（15.0 个月对 9.0 个月，p = 0.06）。肝外转移是预后不良的独立危险因素。