PMID- 32167170
OWN - NLM
STAT- MEDLINE
DCOM- 20210408
LR  - 20210408
IS  - 1097-0215 (Electronic)
IS  - 0020-7136 (Linking)
VI  - 147
IP  - 7
DP  - 2020 Oct 1
TI  - Effectiveness of sorafenib dose modifications on treatment outcome of 
      hepatocellular carcinoma: Analysis in real-life settings.
PG  - 1970-1978
LID - 10.1002/ijc.32964 [doi]
AB  - Controlling adverse events (AEs) through dose reduction can enhance drug 
      adherence and treatment response. Currently, there is no guide for sorafenib 
      dosing. The aim of this study was to evaluate whether sorafenib dosing could 
      affect treatment outcomes. A total of 782 hepatocellular carcinoma (HCC) patients 
      treated with sorafenib were evaluated for sorafenib dosing and its modifications 
      via medical records at baseline and regular follow-up. Study outcomes included 
      progression-free survival (PFS), overall survival (OS), sorafenib duration, 
      cumulative dose, AEs and drug discontinuation. The median patient survival was 
      7.7 months. Overall, 242 (30.9%) patients underwent dose reduction and 121 
      (17.5%) discontinued sorafenib due to AEs. In multivariate analysis, dose 
      reduction was identified to be independently predictive of PFS and OS. The 
      800-to-400 mg/day group provided significantly better PFS than the 
      800 mg/day-maintained group or the 800-to-600 mg/day group. Likewise, the 
      800-to-400 mg/day group resulted in a significantly better OS than other dosing. 
      However, dose reduction to 200 mg/day led to significantly worse PFS and OS. 
      Hand-foot skin reaction and drug discontinuation due to AEs were higher in the 
      800-to-600 mg/day group than the 800-to-400 mg/day group. The 800-to-400 mg/day 
      group had significantly longer treatment duration and higher cumulative dose than 
      the 800 mg/day-maintained group. Sorafenib dose reduction can improve HCC 
      survival and increase patient tolerance and adherence coupled with longer 
      duration and higher cumulative dose. Dose reduction from 800 to 400 mg/day than 
      to 600 mg/day is recommended when clinically warranted. However, dose reduction 
      to 200 mg/day is not recommendable.
CI  - (c) 2020 UICC.
FAU - Tak, Kwon Yong
AU  - Tak KY
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
FAU - Nam, Hee Chul
AU  - Nam HC
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
FAU - Choi, Jong Young
AU  - Choi JY
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
FAU - Yoon, Seung Kew
AU  - Yoon SK
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
FAU - Kim, Chang Wook
AU  - Kim CW
AD  - Uijeongbu St. Mary's Hospital, Seoul, South Korea.
FAU - Kim, Hee Yeon
AU  - Kim HY
AD  - Uijeongbu St. Mary's Hospital, Seoul, South Korea.
FAU - Lee, Sung Won
AU  - Lee SW
AUID- ORCID: 0000-0002-5194-5130
AD  - Bucheon St. Mary's Hospital, Seoul, South Korea.
FAU - Lee, Hae Lim
AU  - Lee HL
AD  - Bucheon St. Mary's Hospital, Seoul, South Korea.
FAU - Chang, U Im
AU  - Chang UI
AD  - St. Vincent's Hospital, Seoul, South Korea.
FAU - Song, Do Seon
AU  - Song DS
AD  - St. Vincent's Hospital, Seoul, South Korea.
FAU - Yang, Jin Mo
AU  - Yang JM
AD  - Incheon St. Mary's Hospital, Seoul, South Korea.
FAU - Kwon, Jung Hyun
AU  - Kwon JH
AUID- ORCID: 0000-0002-5484-5864
AD  - Incheon St. Mary's Hospital, Seoul, South Korea.
FAU - Yoo, Sun Hong
AU  - Yoo SH
AD  - Incheon St. Mary's Hospital, Seoul, South Korea.
FAU - Sung, Pil Soo
AU  - Sung PS
AUID- ORCID: 0000-0002-5780-9607
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
FAU - Choi, Sang Wook
AU  - Choi SW
AD  - St. Paul's Hospital, Seoul, South Korea.
FAU - Song, Myeong Jun
AU  - Song MJ
AD  - Daejeon St. Mary's Hospital, Seoul, South Korea.
FAU - Kim, Seok Hwan
AU  - Kim SH
AD  - Daejeon St. Mary's Hospital, Seoul, South Korea.
FAU - Jang, Jeong Won
AU  - Jang JW
AUID- ORCID: 0000-0003-3255-8474
AD  - Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, 
      Seoul, South Korea.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200331
PL  - United States
TA  - Int J Cancer
JT  - International journal of cancer
JID - 0042124
RN  - 0 (Antineoplastic Agents)
RN  - 9ZOQ3TZI87 (Sorafenib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*administration & dosage/adverse effects
MH  - Carcinoma, Hepatocellular/*drug therapy
MH  - Dose-Response Relationship, Drug
MH  - Drug Tapering
MH  - Female
MH  - Humans
MH  - Liver Neoplasms/*drug therapy
MH  - Male
MH  - Medication Adherence
MH  - Middle Aged
MH  - Sorafenib/*administration & dosage/adverse effects/therapeutic use
MH  - Survival Analysis
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - dose modification
OT  - dose reduction
OT  - hepatocellular carcinoma
OT  - progression-free survival
OT  - sorafenib
EDAT- 2020/03/14 06:00
MHDA- 2021/04/10 06:00
CRDT- 2020/03/14 06:00
PHST- 2019/11/06 00:00 [received]
PHST- 2020/02/28 00:00 [revised]
PHST- 2020/03/03 00:00 [accepted]
PHST- 2020/03/14 06:00 [pubmed]
PHST- 2021/04/10 06:00 [medline]
PHST- 2020/03/14 06:00 [entrez]
AID - 10.1002/ijc.32964 [doi]
PST - ppublish
SO  - Int J Cancer. 2020 Oct 1;147(7):1970-1978. doi: 10.1002/ijc.32964. Epub 2020 Mar 
      31.