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Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

5553 - Clinicopathological evaluation of skin lesions (SL) in patients with hepatocellular carcinoma (HCC) treated with sorafenib

Date

21 Oct 2018

Session

Poster display session: Basic science, Endocrine tumours, Gastrointestinal tumours - colorectal & non-colorectal, Head and neck cancer (excluding thyroid), Melanoma and other skin tumours, Neuroendocrine tumours, Thyroid cancer, Tumour biology & pathology

Topics

Supportive Care and Symptom Management

Tumour Site

Hepatobiliary Cancers

Presenters

Leonardo Fonseca

Citation

Annals of Oncology (2018) 29 (suppl_8): viii205-viii270. 10.1093/annonc/mdy282

Authors

L.G.D. Fonseca1, A. Díaz2, V. Sapena1, Á. Díaz-González1, L. Boix1, M. Sanduzzi-Zamparelli1, C. Fuster2, N. Llarch1, G. Iserte1, F. Torres3, J. Bruix4, M. Reig1

Author affiliations

  • 1 Bclc Group. Liver Unit, Hospital Clínic of Barcelona. IDIBAPS. CIBERehd, 69 - Barcelona/ES
  • 2 Department Of Pathology, Hospital Clínic of Barcelona. IDIBAPS. CIBERehd, 69 - Barcelona/ES
  • 3 Medical Statistics Core Facility, Hospital Clínic of Barcelona. IDIBAPS. CIBERehd, 69 - Barcelona/ES
  • 4 Bclc Group, Liver Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBEREHD, Barcelona/ES
More

Resources

Abstract 5553

Background

Dermatologic adverse events (DAE) are frequently experienced in patients under sorafenib. Although the majority appear as rash or hand-foot reaction, some patients may present SL requiring biopsy or local procedures that may impact in the treatment. While there are series of patients with melanoma and BRAF inhibitors presenting SL, there is no information on HCC patients with sorafenib.

Methods

We analyzed a prospective database of patients with HCC treated with sorafenib. Patients who developed biopsed SL were included and the pathology samples were reviewed.

Results

Between oct-2007 and jan-2018, 313 patients were treated with sorafenib (54.6% BCLC-C, 88.7% ECOG-PS0 and 83.6% CPA), 88 (28.1%) presented DAE in the first 60 days (eDAE) and 24 (7.7%) developed SL submitted to excisional biopsy. From the 24 patients, 33 SL were biopsied and 5 patients presented more than 1 SL. Most of the patients with SL were male (79.2%), CPA (87.5%), HCV etiology (87.5%) and 2 had liver transplantation. The median time from sorafenib initiation until SL biopsy was 8.5 months (IQR 4.4 to 18.1). SL are described in the table. Lymphocyte proliferation at the interface between the SL and dermis was noted in 61.1%. The median treatment duration (MTD) and OS in the whole cohort were 6.5 months [IQR 3.3-13.9] and 13.6 months [CI95% 12.2- 15.6], respectively. For the subgroup with SL, the MTD and OS was 12.5 [9.5 - 22.0] and 26.5 months [CI95% 17.0 - 43.9], respectively. For those with both eDEA and SL, the MTD and OS was 17.9 months [7.7-28.9] and 26.5 [22.0-51.6] respectively. There was no permanent discontinuation related to the SL.Table: 705P

SL subtypes

n = 33 lesions (100%)
Tumor SL22 (66.7%)
Keratoacanthomas7 (21.2%)
Squamous cell carcinomas5 (15.2%)
Basal cell carcinomas3 (9.1%)
Seborrheic queratosis3 (9.1%)
Hypertrophic keratoma1 (3%)
Sebaceous hyperplasia1 (3%)
Pilomatrixioma1 (3%)
Trichilemmal cyst1 (3%)
Non-Tumor SL7 (21.2)
Suppurative folliculitis2 (6.1%)
Interphase dermatitis2 (6.1%)
Subacute spongiform dermatitis1 (3%)
Septal panniculitis/ Erythema nodosum1 (3%)
Lichen planus1 (3%)
Livedo reticularis2 (6.1%)
Thrombotic vasculopathy1 (3%)
Epi/Hypodermic necrosis1 (3%)

Conclusions

This is the largest series on patients with HCC and sorafenib that presented biopsed SL. Similar to other tumors treated with BRAF inhibitors, patients with HCC and sorafenib are in risk of developing SL. Interestingly, the majority presented lymphocyte proliferation. This reinforces the need to understand the immune modulation by sorafenib.

Clinical trial identification

Legal entity responsible for the study

BCLC group.

Funding

Has not received any funding.

Editorial Acknowledgement

Disclosure

All authors have declared no conflicts of interest.

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