Long duration of stable disease may improve overall survival in patients with advanced hepatocellular carcinoma treated with sorafenib

【PURPOSE】 Sorafenib is a molecularly-targeted drug, which have been proven survival benefit for advanced hepatocellular carcinoma (HCC). Because of the unique side effects of sorafenib such as hand-foot skin reaction (HFSR), the administration of sorafenib is often discontinued. We compared the efficacy of overall survival (OS) in the view of the duration of stable disease (SD). 【METHODS】 112 patients with advanced HCC have been treated with sorafenib in our hospital. They were evaluated the antitumor response according to the modified Response Evaluation Criteria in Solid Tumor. We compared the relationship between the duration of SD and OS. 【RESULTS】 Complete response (CR) was observed in 2 patients, partial response (PR) in 16 patients, SD in 36 patients and progression disease (PD) in 27 patients, respectively. CR+PR patients (CR+PR group) had Child-Pugh A/B=18/0, BCLC stage A/B/C=3/6/9 and HBV/HCV/NBNC=6/8/4. SD patients (SD group) had Child-Pugh A/B=30/6, BCLC stage A/B/C=16/6/14 and HBV/HCV/NBNC=5/20/11. In the SD group the median duration of SD was 3.3 months. The SD group was divided into two groups; less than three months defined as Short SD and more than three months defined as Long SD. We compared the relationship of overall survival between the group of PR, Long SD, and Short SD. In the Short SD group, the median OS was 6.2 months (95%C.I. 4.7-7.3). In the Long SD group, the median OS was 17.6 months (95%C.I. 10.4-23.6). In the CR+PR Group, the median OS was 19.1 months (95%C.I. 14.2-23.8). There was not statistically significant difference between the OS of CR+PR group and the OS of Long SD group, however, there was statistically significant difference between the OS of Long SD group and the OS of Short SD group. 【CONCLUSION】 In the treatment of sorafenib for advanced HCC, long duration of SD improves the OS as same as CR+PR. Controlling the unique side effects of sorafenib such as HFSR is important to obtain the longer treatment duration.