736P - The use of SECOX (sorafenib, oxaliplatin, capcitabine) as the treatment of advanced hepatocellular carcinoma (HCC) - a single center retrospective s...

Date 30 September 2012
Event ESMO Congress 2012
Session Poster presentation II
Topics Anti-Cancer Agents & Biologic Therapy
Hepatobiliary Cancers
Presenter Joanne Chiu
Authors J. Chiu1, V. Tang2, P. Chan3, R. Leung2, H. Wong2, R.T.P. Poon4, S.T. Fan4, T. Yau2
  • 1Medicine, Queen Mary Hospital, The University of Hong Kong, - - Hong Kong/CN
  • 2Medicine, Queen Mary Hospital, The University of Hong Kong, - - -/HK
  • 3Medicine, Ruttonjee Hospital, - - -/HK
  • 4Surgery, Queen Mary Hospital, The University of Hong Kong, - - -/HK

Abstract

Background

Combining sorafenib with chemotherapy can potentially provide a new regime with enhanced benefit. Phase II study has demonstrated promising activity in combining sorafenib, oxaliplatin and capecitabine (SECOX) in treating advanced HCC. We reported our experience in using this regime in our centre.

Methods

This retrospective study included all consecutive advanced HCC patients treated in our centre with SECOX regimen: daily oral sorafenib 400 mg B.D., oxaliplatin 85 mg/m2 infusion on D1, and oral capecitabine 850 mg/m2 B.D. from D1-7 every 2 weeks. Univariate and multivariate analyses were employed to explore the potential predictive factors for overall survival benefits treated with this combination.

Results

89 patients were included in the analysis with 29 patients previously enrolled in the phase II trial and 60 patients treated outside the clinical trial in our centre. Of 89 patients received SECOX (male, 85%; median age, 53 year; hepatitis B carrier, 91%), 72 (81%) patients had CP A and 17 (29%) patients had CP B. Moreover, 42.7% patients had ECOG performance status (PS) 0, 53.9 % patients had PS 1 and 3.4% patients had PS 2. The most common grade 3 or 4 drug-related toxicities were hand-foot syndrome (10.5%), diarrhea (5.8%), and hypertension (5.8%). G3/4 thrombocytopenia was found in 18.1% and neutropenia was present in 6.0%. The overall response rate was 14.6%, with one (1.1%) patient had complete response and 12 (13.5%) patients achieved partial response. Moreover, 30 (33.7%) patients had stable disease. Overall, 48.3% patients derived benefits from SECOX. The progression-free survival (PFS) was 4.1 months (95% C.I. 3.6-4.6) and median overall survival (OS) was 11.0 months (95% C.I. 8.2-12.3). Patients with CP A cirrhosis had better PFS (4.2 vs 2.9 months, p = 0.027) and OS (11.8 vs 5.0 months, p = 0.003) than CP B patients. Multivariate analysis revealed that both ECOG 1-2 (p = 0.005) and vascular involvement (p = 0.048) were associated with worse overall survival.

Conclusions

The SECOX regime had promising activity in advanced HCC with good tolerability, especially in Child-Pugh A patients with good performance status.

Disclosure

R. Poon: Advisory board with Bayer.

T. Yau: Advisory board with Bayer.

All other authors have declared no conflicts of interest.