PMID- 22354124
OWN - NLM
STAT- MEDLINE
DCOM- 20120517
LR  - 20181201
IS  - 1423-0232 (Electronic)
IS  - 0030-2414 (Linking)
VI  - 82
IP  - 2
DP  - 2012
TI  - Sorafenib dose escalation in the treatment of advanced hepatocellular carcinoma.
PG  - 119-25
LID - 10.1159/000336082 [doi]
AB  - OBJECTIVE: Although sorafenib has shown survival benefits in patients with 
      hepatocellular carcinoma (HCC), many patients require discontinuation or dose 
      reduction due to adverse events (AEs). We applied a dose escalation scheme to 
      increase patient compliance and avoid AEs. METHODS: Of 267 HCC patients treated 
      with first-line sorafenib, 25 at increased risk of AEs, including those with 
      advanced liver cirrhosis, a history of liver transplantation, or cytopenia, 
      received the dose escalation scheme. They started on a reduced dose of sorafenib 
      which increased to the standard dosage according to tolerance in each patient. We 
      analyzed the efficacy and safety of the dose escalation scheme. RESULTS: Patients 
      with risk factors showed a lower disease control rate, shorter survival, and more 
      frequently grade 3/4 AEs. Among patients presenting risk factors, the dose scheme 
      did not affect the efficacy of sorafenib or survival, but reduced the incidence 
      of grade 3/4 AEs. Rates of sorafenib discontinuation and dose reduction related 
      to AEs were also lower in the dose escalation group. Dose escalation to the 
      standard dose of sorafenib was achieved in 16 of the 25 patients in the dose 
      escalation group (64.0%). After 2 weeks, the dose intensity of sorafenib did not 
      differ between the two dose schemes. CONCLUSIONS: The sorafenib dose escalation 
      scheme may increase patient compliance and tolerance to prolonged treatment, thus 
      enhancing the efficacy of sorafenib in patients at high risk of AEs or with poor 
      tolerance. Further prospective analyses are needed to determine the usefulness of 
      the dose escalation scheme.
CI  - Copyright (c) 2012 S. Karger AG, Basel.
FAU - Kim, Jeong Eun
AU  - Kim JE
AD  - Department of Oncology, Asan Medical Center, University of Ulsan College of 
      Medicine, Seoul, Korea.
FAU - Ryoo, Baek-Yeol
AU  - Ryoo BY
FAU - Ryu, Min-Hee
AU  - Ryu MH
FAU - Chang, Heung-Moon
AU  - Chang HM
FAU - Suh, Dong Jin
AU  - Suh DJ
FAU - Lee, Han Chu
AU  - Lee HC
FAU - Lim, Young-Suk
AU  - Lim YS
FAU - Kim, Kang Mo
AU  - Kim KM
FAU - Kang, Yoon-Koo
AU  - Kang YK
LA  - eng
PT  - Journal Article
DEP - 20120217
PL  - Switzerland
TA  - Oncology
JT  - Oncology
JID - 0135054
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Benzenesulfonates)
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Pyridines)
RN  - 25X51I8RD4 (Niacinamide)
RN  - 9ZOQ3TZI87 (Sorafenib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*administration & dosage
MH  - Benzenesulfonates/*administration & dosage/adverse effects
MH  - Carcinoma, Hepatocellular/*drug therapy/mortality/pathology
MH  - Female
MH  - Humans
MH  - Liver Neoplasms/*drug therapy/mortality/pathology
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Niacinamide/analogs & derivatives
MH  - Phenylurea Compounds
MH  - Pyridines/*administration & dosage/adverse effects
MH  - Sorafenib
EDAT- 2012/02/23 06:00
MHDA- 2012/05/18 06:00
CRDT- 2012/02/23 06:00
PHST- 2011/07/12 00:00 [received]
PHST- 2011/12/23 00:00 [accepted]
PHST- 2012/02/23 06:00 [entrez]
PHST- 2012/02/23 06:00 [pubmed]
PHST- 2012/05/18 06:00 [medline]
AID - 000336082 [pii]
AID - 10.1159/000336082 [doi]
PST - ppublish
SO  - Oncology. 2012;82(2):119-25. doi: 10.1159/000336082. Epub 2012 Feb 17.