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Equivalent Clinical Outcomes With Sorafenib in Younger and Older Patients With Advanced HCC
Researchers presented the results of their retrospective analysis at the virtual ESMO 23rd World Congress on Gastrointestinal Cancer, which suggested that low-dose sorafenib is equally as clinically effective young patients with advanced hepatocellular carcinoma (HCC) as it is in elderly patients with the disease.
“Sorafenib has been the standard of care for patients with advanced HCC for 13 years, but safety data and outcomes in older patients are inconclusive,” wrote Vidales Sepulveda, MD, Department of Medical Oncology, Institut Catalá d’Oncologia, and fellow co-authors, who spearheaded the study.
The end points were overall survival (OS), progression-free survival (PFS), response rate and incidences of adverse events (AEs). These variables were compared between 157 (77%) young patients and 45 (22%) elderly with the Mann-Whitney U test for continuous variables and chi-2 or Fisher’s exact test for categoric variables.
Of note, elderly patients were more likely to have arterial hypertension (44.87% vs 66.22%, respectively) and HCV-related aetiology (44.59% vs 62.22%), and were more likely to have received prior treatment with >2 transarterial chemoembolization (25.64% vs 43.18%).
Findings showed no differences in the OS of younger versus elderly patients (15.31 vs 13.93 months, respectively), and that the statistical impact of age on PFS (8.77 vs 5.85 months), initial low dose therapy, and response rate was not present.
Furthermore, elderly patients did not experience a higher incidence of AEs compared with the younger patients, and there were no statistical differences in the rate of discontinuation of sorafenib due to toxicity between both younger and older patients (30.4% vs 42.2%, respectively).
“Elderly patients with advanced HCC, when treated with sorafenib, have equivalent clinical outcomes with similar toxicity rates as the younger patients. Age alone should be a discriminating factor in the management of advanced HCC,” concluded Dr Vidales et al.—Alexa Stoia
Vidales S, Gómez S, Laquente S, et al. Safety and effectiveness of sorafenib in elderly patients diagnosed with advanced hepatocellular carcinoma in a monographic oncologic center. Presented at: the ESMO 23rd World Congress on Gastrointestinal Cancer; June 30-July 3, 2020; virtual. Abstract P-153.
