Impact of age on sorafenib outcomes in hepatocellular carcinoma: an international cohort study.
Motedayеn Aval, Leila
Taddei, Tamar H
Kaplan, David E
Pinato, David J
Br J Cancer
Springer Science and Business Media LLC
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Hajiev, S., Allara, E., Motedayеn Aval, L., Arizumi, T., Bettinger, D., Pirisi, M., Rimassa, L., et al. (2021). Impact of age on sorafenib outcomes in hepatocellular carcinoma: an international cohort study.. Br J Cancer, 124 (2), 407-413. https://doi.org/10.1038/s41416-020-01116-9
BACKGROUND: There is no consensus on the effect of sorafenib dosing on efficacy and toxicity in elderly patients with hepatocellular carcinoma (HCC). Older patients are often empirically started on low-dose therapy with the aim to avoid toxicities while maximising clinical efficacy. We aimed to verify whether age impacts on overall survival (OS) and whether a reduced starting dose impacts on OS or toxicity experienced by the elderly. METHODS: In an international, multicentre cohort study, outcomes for those aged <75 or ≥75 years were determined while accounting for common prognostic factors and demographic characteristics in univariable and multivariable models. RESULTS: Five thousand five hundred and ninety-eight patients were recruited; 792 (14.1%) were aged ≥75 years. The elderly were more likely to have larger tumours (>7 cm) (39 vs 33%, p < 0.01) with preserved liver function (67 vs 57.7%) (p < 0.01). No difference in the median OS of those aged ≥75 years and <75 was noted (7.3 months vs 7.2 months; HR 1.00 (95% CI 0.93-1.08), p = 0.97). There was no relationship between starting dose of sorafenib 800 mg vs 400 mg/200 mg and OS between those <75 and ≥75 years. The elderly experienced a similar overall incidence of grade 2-4 sorafenib-related toxicity compared to <75 years (63.5 vs 56.7%, p = 0.11). However, the elderly were more likely to discontinue sorafenib due to toxicity (27.0 vs 21.6%, p < 0.01). This did not vary between different starting doses of sorafenib. CONCLUSIONS: Clinical outcomes in the elderly is equivalent to patients aged <75 years, independent of dose of sorafenib prescribed.
Article, /692/699/67/1059/602, /692/4028/67/1504/1610/4029, article
External DOI: https://doi.org/10.1038/s41416-020-01116-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/329620