Background and Aim
Sorafenib is recommended as a standard treatment for advanced hepatocellular carcinoma (HCC). The efficacy and safety of sorafenib as a first‐line therapy in Korean patients with advanced HCC were investigated.
Methods
From 2007 to 2012, 86 patients with advanced HCC (Barcelona Clinic Liver Cancer stage C) treated with sorafenib as a first‐line therapy were enrolled from five tertiary hospitals. Predictors of overall survival (OS) and progression‐free survival (PFS) were analyzed.
Results
The median age was 59.5 years, and 71 (82.6%) were males; 57 (66.3%) patients were in Child–Pugh class A. The median OS and PFS were 5.0 (range 4.0–5.9) and 3.2 (range 2.6–3.7) months, respectively. Regarding OS, Child–Pugh class A (6.0 vs 2.8 months), tumor diameter < 5 cm (6.0 vs 4.3 months), baseline α‐fetoprotein < 200 ng/mL (5.8 vs 4.1 months), and the advent of hand‐foot‐skin reaction of ≥ grade 2 (5.9 vs 4.0 months) were independent favorable predictors (all P < 0.05). Similarly, regarding PFS, Child–Pugh class A (4.3 vs 2.1 months), tumor diameter < 5 cm (3.9 vs 2.8 months), baseline α‐fetoprotein < 200 ng/mL (5.6 vs 2.8 months), and the advent of hand‐foot‐skin reaction of ≥ grade 2 (4.5 vs 2.6 months) were independent favorable predictors (all P < 0.05). All toxicities during sorafenib treatment were manageable.
Conclusions
Because the efficacy of sorafenib seems marginal in Korean patients with treatment‐naïve HCC, how to select candidates with favorable outcomes should be further investigated.