466P - The safety and efficacy of sorafenib combined with transarterial chemoembolization for patients with unresectable hepatocellular carcinoma

Date 01 October 2012
Event ESMO Congress 2012
Session Poster presentation III
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Presenter Wenbo Shao
Authors W. Shao, N. Cong, J. Song
  • Interventional Therapy, Shandong Cancer Hospital and Institute, 250117 - Jinan/CN


Background and aim

Transarterial chemoembolization(TACE) is widely used for unresectable hepatocellular carcinoma. However, the hypoxia caused by TACE in surviving tumor cell leads to release of angiogenic and growth factors contributing to poor outcome. Sorafenib can block tumor cell proliferation and angiogenesis. The hypothesis is that patients with unresectable HCC may benefit from sorafenib in combination with TACE.


This is a retrospective study involving patients with unresectable HCC who had received at least one TACE session. Patients received sorafenib 400 mg twice per day and were monitored monthly. Dose reduction from 400mg to 200mg of sorafenib bid was permitted. The primary outcome is safety. The second outcome is overall survival.


Twenty one patients (mean age, 58 years; Child-Pugh class A, 100%; ECOG PS 0, 100%; BCLC B, 36.8%; BCLC C, 63.2%) were included from April, 2009 to February, 2011. The mean TACE sessions prior to or after sorafenib administration were 4.3 ± 2.9 and 1.5 ± 0.4 respectively. All patients were treated with sorafenib despite radiographic progression until there was deterioration in patient's Child-Pugh class to C, ECOG PS score to 4, or had intolerant adverse events or death. Two patients quitted the study for intolerant diarrhea and withdrawn of consent, respectively. Of the other 19 patients, no grade 3 or 4 adverse events were observed. The most common toxicities were dermatology adverse effects (94.7%), diarrhea (63.2%) and alopecia (26.3%). Sorafenib dose was reduced temporarily in 14 patients (73.7%). Most of toxicities could be relieved after dose reductions and not aggravated again even the dose of sorafenib resumed to 400 mg bid. Five patients remained on sorafenib as of February 29, 2012, and were censored at that time point. The median survival was 12 months (9.2-14.8 months.


The combination of sorafenib and TACE for unresectable HCC is safe providing that dose adjustment is permitted. The survival benefit is promising.


All authors have declared no conflicts of interest.