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
MetadataShow full item record
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.
Adult, Age Factors, Aged, Aged, 80 and over, Antineoplastic Agents, Carcinoma, Hepatocellular, Cohort Studies, Dose-Response Relationship, Drug, Female, Humans, Liver Neoplasms, Male, Middle Aged, Prognosis, Sorafenib, Treatment Outcome
External DOI: https://doi.org/10.1038/s41416-020-01116-9
This record's URL: https://www.repository.cam.ac.uk/handle/1810/329620
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