TITLE:
Time to Progression of AFP (TPA) as a Predictor of Survival in Hepatocellular Carcinoma Treated with Sorafenib (SOR)
AUTHORS:
Maria Varela, Olegario Castaño-Fernández, Marcelo Garrido, Lorena Blanco-García, Pablo Martínez-Camblor, Alicia Mesa-Álvarez, Carmen Navascués, Valle Cadahía-Rodrigo, Rafael Menéndez de Llano, Ramon Pérez-Álvarez, Maria Luisa González-Diéguez, Manuel Rodríguez
KEYWORDS:
Hepatocellular Carcinoma, Targeted Therapy, AFP, Sorafenib, Prognostic Value, Overall Survival
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.5 No.14,
December
3,
2014
ABSTRACT: Background: The standard
therapy in advanced hepatocellular carcinoma (HCC) is sorafenib (SOR), which has the inconvenience of
toxicity and discontinuation. Patient selection and the use of early markers
are critical for optimizing the potential benefit of SOR. Alpha-fetoprotein
(AFP) has an established role in HCC prognosis. The objective was to evaluate
whether AFP variation during SOR treatment reflects the lack of progression to
SOR and can be used as a prognostic factor. Methods:
AFP levels were prospectively analyzed in 114 patients to determine whether the
time to progression of AFP (TPA) at 3 months had a prognostic value for
survival. Results: Between July 2007 and October 2012, 114 patients were
included (mean age 64 years, 97 male, 96 with cirrhosis). Etiology was alcohol
47 (41%) and hepatitis C virus (HCV) 31 (27%). According to the Barcelona Clinic
Liver Cancer (BCLC) staging system: A (one case), B (24 cases) and C (89 cases). The Child-Pugh was Class A in 89
cases. The general condition of the patient according to ECOG-PS was 0 in 73
cases. The median duration of treatment was 5 months (3.47 - 6.53, 95% CI). The
median overall survival (OS) was 9.23 months. The standard dose was maintained
in 26 patients (22.8%). Sixty-seven percent of patients experienced at least
one adverse event grade 3-4. The time to progression of AFP lower or higher
than 3 months was an independent prognostic factor of OS (univariate and
multivariate analysis): 8.10 vs. 18.85 months, P 3 months had longer OS, and TPA was an
independent prognostic factor.