[Therapeutic decisions in the treatment of hepatocellular carcinoma and patterns of sorafenib use. Results of the international observational GIDEON trial in Spain]

Gastroenterol Hepatol. 2015 Apr;38(4):263-73. doi: 10.1016/j.gastrohep.2014.11.001. Epub 2015 Jan 9.
[Article in Spanish]

Abstract

Introduction: GIDEON is a non-interventional, prospective, international study that evaluated the safety of sorafenib in patients with unresectable hepatocellular carcinoma (HCC) in daily clinical practice, including Child-Pugh B patients.

Objectives: To analyze data collected in Spain on the safety and efficacy of sorafenib and treatment patterns.

Methods: Data were collected during follow-up on demographic and disease characteristics, the initial dose used, treatment-emergent adverse events (AEs) and dose modifications. Overall survival was evaluated, as well as time to disease progression. Efficacy and safety were analyzed according to the Child-Pugh classification and the initial dose.

Results: We included 143 patients from 19 Spanish hospitals. A total of 24.5% of the patients were Child-Pugh B. An initial dose of 400 mg/12 h was used in 90.9% of patients. In Child-Pugh A patients, dose modifications occurred more frequently and the treatment duration was longer. The incidence of AEs and drug-related AEs were similar in Child-Pugh A and B patients, although serious AEs were more frequent in Child-Pugh B patients. The most common AEs were diarrhea, fatigue and hand-foot skin reactions. The median overall survival was 384 days and was higher in Child-Pugh A patients (593 vs. 211 days in Child-Pugh B). The median time to disease progression was 177 days, similar in both subgroups.

Conclusion: The safety profile of sorafenib in Spanish patients with unresectable HCC is independent of liver function. Child-Pugh status does not seem to influence the approach to sorafenib dosage or time to progression but does seem to be a strong prognostic factor for survival.

Keywords: Carcinoma hepatocelular; Efficacy; Eficacia; GIDEON; Hepatocellular carcinoma; Safety; Seguridad; Sorafenib.

Publication types

  • Clinical Trial, Phase IV
  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / therapy
  • Combined Modality Therapy
  • Diarrhea / chemically induced
  • Disease Progression
  • Disease-Free Survival
  • Dose-Response Relationship, Drug
  • Fatigue / chemically induced
  • Female
  • Hand-Foot Syndrome / etiology
  • Humans
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / therapy
  • Male
  • Middle Aged
  • Niacinamide / adverse effects
  • Niacinamide / analogs & derivatives*
  • Niacinamide / therapeutic use
  • Phenylurea Compounds / adverse effects
  • Phenylurea Compounds / therapeutic use*
  • Prospective Studies
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use*
  • Salvage Therapy
  • Severity of Illness Index
  • Sorafenib
  • Spain
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Phenylurea Compounds
  • Protein Kinase Inhibitors
  • Niacinamide
  • Sorafenib