700P - Comparison of prognostic models for hepatocellular carcinoma (HCC) in patients treated with the sorafenib: Results from a Canadian Multi-center HCC...

Date 09 September 2017
Event ESMO 2017 Congress
Session Poster display session
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Gastrointestinal Cancers
Presenter Haider Samawi
Citation Annals of Oncology (2017) 28 (suppl_5): v209-v268. 10.1093/annonc/mdx369
Authors H.H. Samawi1, S. Hao-Wen2, K. Chan3, M.A. Alghamdi4, R.M. Lee-Ying4, J. Knox2, P. Gill1, A. Romagnino3, E. Batuyong4, Y. Ko3, W.Y. Cheung4, V.C. Tam4
  • 1Medical Oncology, British Columbia Cancer Agency, V5Z 4E6 - Vancouver/CA
  • 2Medical Oncology And Hematology, Princess Margaret Cancer Centre, University Health Network, M5G 1Z5 - Toronto/CA
  • 3Medical Oncology, Sunnybrook Odette Cancer Centre, M4N 3M5 - Toronto/CA
  • 4Medical Oncology, Tom Baker Cancer Centre, T2N 4N2 - Calgary/CA

Abstract

Background

Several staging systems and models (TNM, BCLC, Okuda, CLIP and ALBI) have been developed to estimate the prognosis of patients with HCC. Most of these were developed prior to the prevalent use of sorafenib. The purpose of this study was to compare the prognostic and discriminatory power of these models in predicting survival for HCC patients treated with sorafenib.

Methods

Patients who received sorafenib for the treatment of HCC between January 1, 2008 and June 30, 2015 in the provinces of British Columbia and Alberta, as well as Princess Margaret Cancer Centre and Sunnybrook Odette Cancer Centre in Toronto, Ontario were included. Survival outcomes for each model were assessed with Kaplan-Meier (KM) curves and compared with the log-rank test. Time dependent area under the curve (t-AUC) was used to test the discriminatory power of each model (higher t-AUC = more discriminatory power). Akaike information criterion (AIC), a measure of goodness-of fit of models while penalizing overly complex models, was used to compare the models (lower AIC = better model).

Results

A total of 681 patients were included in this analysis. Median age was 64 years (range 8-91). Majority were males (80%), had a Child-Pugh score A (86%), ECOG performance status 0 (30%) and 1 (60%). 37% of patients were of East Asian ethnicity. Most common etiology for liver disease was hepatitis B (33%) and C (29%). At start of sorafenib, most patients were BCLC stage C (92%) and TNM stage IV (61%). The median overall survival for the entire cohort was 9.2 months (95% CI 8-10.4). CLIP had the highest t-AUC and the lowest AIC. See table below for t-AUC and AIC results.Table:

700P

Prognostic modelAICt-AUC (95% CI)
CLIP5725.760.659 (0.601 – 0.718)
Okuda5730.380.645 (0.597 – 0.694)
ALBI5756.730.558 (0.510 – 0.599)
BCLC5759.250.558 (0.518 – 0.599)
TNM stage5771.510.561 (0.499 – 0.623)

Conclusions

According to our large multi-center study, CLIP appears to be the most informative in predicting survival in HCC patients treated with sorafenib. Prospective studies are needed to determine its role in patient selection for clinical trials and in guiding treatment decisions. The TNM and BCLC staging systems were the least useful in predicting survival in this population.

Clinical trial identification

Legal entity responsible for the study

CHORD Consortium

Funding

None

Disclosure

All authors have declared no conflicts of interest.