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

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Abstract

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.

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Funding

This work was supported by a grant from the National Natural Science Foundation of China (No. 81873919).

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Author notes

  1. Yanyan Cao and Tao Ouyang have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, Hubei, China

    Yanyan Cao, Tao Ouyang, Fu Xiong, Xuefeng Kan, Lei Chen, Bin Liang & Chuansheng Zheng

  2. Hubei Province Key Laboratory of Molecular Imaging, Wuhan, 430022, Hubei, China

    Yanyan Cao, Tao Ouyang, Fu Xiong, Xuefeng Kan, Lei Chen, Bin Liang & Chuansheng Zheng

Authors
  1. Yanyan Cao
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  2. Tao Ouyang
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  3. Fu Xiong
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  4. Xuefeng Kan
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  7. Chuansheng Zheng
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Contributions

Chuansheng Zheng conceived and designed the study. Yanyan Cao contributed significantly to analysis and manuscript preparation. Tao Ouyang performed the data analysis and wrote the manuscript. Fu Xiong, Xuefeng Kan, Lei Chen, and Bin Liang helped to perform the analysis with constructive discussions. All authors read and approved the manuscript.

Corresponding author

Correspondence to Chuansheng Zheng.

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Conflict of interest

The study was conducted according to the Declaration of Helsinki. Informed consent was waived for the retrospective type of this study. The information of all participants is maintained with confidentiality. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Consent to participates

All patients were informed that apatinib was an alternative treatment, because the first-line sorafenib–TACE treatment was ineffective. Moreover, all patients were informed of the economic cost, anticipated outcomes, and potential toxicity. Final treatment decisions were made by the patients.

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Cao, Y., Ouyang, T., Xiong, F. et al. Efficacy of apatinib in patients with sorafenib–transarterial chemoembolization refractory hepatocellular carcinoma: a retrospective study. Hepatol Int 15, 1268–1277 (2021). https://doi.org/10.1007/s12072-021-10198-3

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  • DOI: https://doi.org/10.1007/s12072-021-10198-3

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