2.Sorafenib for advanced hepatocellular carcinoma: a systematic review.
Zou LING-LIN ; Ma LI ; Tian JIN-HUI ; Yang KE-HU
Acta Academiae Medicinae Sinicae 2011;33(1):51-57
OBJECTIVETo evaluate the effectiveness and toxicity of sorafenib for advanced hepatocellular carcinoma.
METHODSAccording to the Cochrane handbook for systematic review, two reviewers independently completed the whole process of literature search, study selection, data collection, and quality assessment. Seven electric databases(PubMed, Cochrane Library, Embase, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientific and Technical Journal Database, Chinese Medical Association Digital Periodicals Database) were searched and randomized controlled trials (RCT) of sorafenib in the treatment of advanced hepatocellular carcinoma were collected and analyzed.
RESULTSTwo RCT involving 828 patients were finally included. Compared with placebo, sorafenib significantly extended the overall survival and time to radiologic progression and improved the disease control rate. The main adverse effects were systemic, gastrointestinal, and dermatologic symptoms (grade 1 or 2 in severity), although the incidences were significantly higher in sorafenib groups than in control groups.
CONCLUSIONSorafenib is effective and safe for the treatment of advanced hepatocellular carcinoma.
Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; Humans ; Liver Neoplasms ; drug therapy ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use
3.Bemusement and strategy on the efficacy of clinical application of targeted anticancer drugs.
Chinese Journal of Oncology 2009;31(9):641-645
Angiogenesis Inhibitors
;
therapeutic use
;
Antibodies, Monoclonal
;
therapeutic use
;
Antibodies, Monoclonal, Humanized
;
Antimetabolites, Antineoplastic
;
therapeutic use
;
Antineoplastic Agents
;
therapeutic use
;
Benzamides
;
Benzenesulfonates
;
therapeutic use
;
Bevacizumab
;
Carcinoma, Hepatocellular
;
drug therapy
;
Carcinoma, Renal Cell
;
drug therapy
;
Deoxycytidine
;
analogs & derivatives
;
therapeutic use
;
Drug Delivery Systems
;
Gastrointestinal Stromal Tumors
;
drug therapy
;
Humans
;
Imatinib Mesylate
;
Indoles
;
therapeutic use
;
Neoplasms
;
drug therapy
;
Niacinamide
;
analogs & derivatives
;
Pancreatic Neoplasms
;
drug therapy
;
Phenylurea Compounds
;
Piperazines
;
therapeutic use
;
Pyridines
;
therapeutic use
;
Pyrimidines
;
therapeutic use
;
Pyrroles
;
therapeutic use
;
Sirolimus
;
analogs & derivatives
;
therapeutic use
4.Clinical observation of the treatment with combination of transcatheter arterial chemoembolization and sorafenib for hepatocellular carcinoma with lung metastasis.
Feng DUAN ; Mao-qiang WANG ; Feng-yong LIU ; Zhi-jun WANG ; Peng SONG
Chinese Journal of Oncology 2009;31(9):716-718
OBJECTIVETo evaluate the safety and efficacy of the combination of transcatheter arterial chemoembolization (TACE) and sorafenib in treatment of hepatocellular carcinoma (HCC) with lung metastasis.
METHODSThirty HCC patients with lung metastasis were treated by the combination of TACE and sorafenib between Oct 2006 and May 2008, including 27 men and 3 women. The age of the patients ranged 32 to 73 years old. Sorafenib was administrated orally at 400 mg, twice daily (the less tolerant patients received 200 mg, bid.), if there was no counterindication, at 3 - 4 weeks after TACE, with every 4 weeks as a course of treatment. The efficacy was evaluated at the end of every course of treatment.
RESULTSThe metastatic lesions in the lung were diminished in 6 cases and stable diseases achieved in 8 cases. The primary liver tumors were stable in 22 cases, including 10 cases achieved by TACE before sorafenib treatment. Eight cases had slightly progressed liver tumors and were treated with 1 - 3 times of TACE in combination with sorafenib. Side effects included skin lesions in 7 cases, hair loss in 6 cases, fatigue in 18 cases, diarrhea in 6 cases, anemia and bone marrow suppression in 5 cases, high blood pressure in 2 cases, and gastrointestinal bleeding in 1 case.
CONCLUSIONThe combination of TACE and sorafenib can be used as an effective treatment for hepatocellular carcinoma patients with lung metastasis, which may stabilize the disease in some patients.
Adult ; Aged ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; secondary ; therapy ; Chemoembolization, Therapeutic ; methods ; Combined Modality Therapy ; Diarrhea ; chemically induced ; Fatigue ; chemically induced ; Female ; Humans ; Liver Neoplasms ; drug therapy ; pathology ; therapy ; Lung Neoplasms ; drug therapy ; secondary ; therapy ; Male ; Middle Aged ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use
5.Therapeutic efficacy and prognostic factors of sorafenib treatment in patients with unresectable primary hepatocellular carcinoma.
Lan ZHANG ; Zheng-gang REN ; Yu-hong GAN ; Yan-hong WANG ; Bo-heng ZHANG ; Yi CHEN ; Xiao-ying XIE ; Nin-ling GE ; Sheng-long YE
Chinese Journal of Oncology 2010;32(8):630-633
OBJECTIVETo evaluate the efficacy and analyze the prognostic factors of sorafenib treatment in patient with unresectable primary hepatocellular carcinoma (HCC).
METHODSDuring the period from December 2005 to March 2009, 50 patients with unresectable primary HCC of Child-Pugh status A were treated with sorafenib (400 mg, Bid). The tumor response was evaluated with CT or MRI imaging every 6 - 8 weeks according to the RECIST criteria. The overall survival (OS) and time to progression (TTP) were defined as the time from administration of sorafenib to the death or the last follow up and were evaluated by Kaplan-Meier method.
RESULTSThere was no PR or CR, but 28 patients (56.0%) achieved stable disease. The median follow up time was 15 months with a median OS of 14 months and median TTP of 4 months. The common adverse events were dermal reaction (68.0%, 34/50), diarrhea (52.0%, 26/50), hypertension (4.0%, 2/50), hair loss (14.0%, 7/50), myelosuppression (16.0%, 8/50), and liver dysfunction (20.0%, 10/50). However, most of the drug-related adverse events were grade I-II and reversible. The patients with lower tumor burden and without distant metastasis had better prognosis.
CONCLUSIONSoafenib is effective for unresectable primary HCC with tolerable toxicity. Tumor stage is a predominant prognostic factor.
Adult ; Aged ; Alopecia ; chemically induced ; Antineoplastic Agents ; adverse effects ; therapeutic use ; Benzenesulfonates ; adverse effects ; therapeutic use ; Carcinoma, Hepatocellular ; drug therapy ; Chemoembolization, Therapeutic ; methods ; Diarrhea ; chemically induced ; Disease Progression ; Follow-Up Studies ; Humans ; Hypertension ; chemically induced ; Liver Neoplasms ; drug therapy ; Male ; Middle Aged ; Neoplasm Staging ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; adverse effects ; therapeutic use ; Skin Diseases ; chemically induced ; Survival Rate
6.Sorafenib in combination with chemotherapy in the induction therapy for FLT3-ITD positive acute monocytic leukemia: a case report and literature review.
Shu-ning WEI ; Hui WEI ; Ying-chang MI ; Bing-cheng LIU ; Kai-qi LIU ; Chun-lin ZHOU ; Qing-hua LI ; Jian-xiang WANG
Chinese Journal of Hematology 2011;32(1):8-11
OBJECTIVETo explore the safety and efficacy of sorafenib in combination with chemotherapy for the treatment of FLT3 positive acute myeloid leukemia (AML), to highlight the impact of FLT3 mutations and targeting therapy on response of AML.
METHODSThe clinical and laboratory features and the treatment response, especially the safety profile of sorafenib in an acute monocytic leukemia patient with FLT-ITD were reported.
RESULTSThe patient achieved clinical and molecular CR after sorafenib was added to the second course of combination chemotherapy. The side effects of sorafenib were mild and tolerable.
CONCLUSIONThe patient responded well to the combination of sorafenib and standard chemotherapy of AML without significant adverse effects.
Adult ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Benzenesulfonates ; administration & dosage ; Female ; Humans ; Leukemia, Monocytic, Acute ; drug therapy ; genetics ; Niacinamide ; analogs & derivatives ; Phenylurea Compounds ; Pyridines ; administration & dosage ; fms-Like Tyrosine Kinase 3 ; genetics
7.Molecular targeting for treatment of advanced hepatocellular carcinoma.
The Korean Journal of Hepatology 2009;15(3):299-308
Hepatocellular carcinoma (HCC) is a major global health problem, which has a grave morbidity and mortality. Over the past few decades, no effective systemic therapeutic modalities have been established for patients with the unresectable HCC in advanced stage. Sorafenib is a small molecule that blocks cancer cell proliferation by targeting the intracellular signaling pathway at the level of Raf-1 and B-Raf serine-threonine kinases, and exerts an anti-angiogenic effect by targeting the vascular endothelial growth factor receptor-1, 2 and 3, and platelet-derived growth factor receptor-beta tyrosine kinases. Recently, two clinical successful applications, SHARP and Asia-Pacific trial, of multikinase inhibitor sorafenib represent a significant advance in the treatment of advanced HCC patients without a curative chance. However, because the results of clinical trials show diverse responses in a subset of HCC patients, a molecular classification of HCC through the excavation of specific biomarkers related to its biological behavior is necessary for sorting HCC patients to each group with a biological homogeneity, ultimately leading to the most suitable individualization of molecular targeted therapy in HCC.
Antineoplastic Agents/therapeutic use
;
Benzenesulfonates/therapeutic use
;
Carcinoma, Hepatocellular/pathology/secondary/*therapy
;
Humans
;
Liver Neoplasms/blood supply/pathology/*therapy
;
Neovascularization, Pathologic
;
Proto-Oncogene Proteins B-raf/antagonists & inhibitors/metabolism
;
Proto-Oncogene Proteins c-raf/antagonists & inhibitors/metabolism
;
Pyridines/therapeutic use
;
Receptors, Platelet-Derived Growth Factor/antagonists & inhibitors/metabolism
;
Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors/metabolism
;
Signal Transduction
8.Primitive neuroectodermal tumor of the kidney with inferior vena cava tumor thrombus during pregnancy response to sorafenib.
Yun-jian WU ; Yu-chun ZHU ; Hui CHEN ; Ying HUANG ; Qiang WEI ; Hui-jiao CHEN ; Xi XIE ; Xiang LI ; Qiao ZHOU ; Yu-ru YANG ; Hao ZENG
Chinese Medical Journal 2010;123(15):2155-2158
Adult
;
Antineoplastic Agents
;
therapeutic use
;
Benzenesulfonates
;
therapeutic use
;
Female
;
Humans
;
Kidney Neoplasms
;
diagnostic imaging
;
drug therapy
;
Neuroectodermal Tumors, Primitive
;
diagnostic imaging
;
drug therapy
;
Niacinamide
;
analogs & derivatives
;
Phenylurea Compounds
;
Pregnancy
;
Pyridines
;
therapeutic use
;
Radiography
;
Thrombosis
;
diagnostic imaging
;
pathology
;
Vena Cava, Inferior
;
diagnostic imaging
;
pathology
9.Current advances in molecular targeted therapy of primary hepatocellular carcinoma.
Lei YU ; Zhi DAI ; Jian ZHOU ; Jia FAN
Chinese Journal of Hepatology 2009;17(6):475-477
Antineoplastic Agents
;
pharmacology
;
therapeutic use
;
Benzenesulfonates
;
therapeutic use
;
Carcinoma, Hepatocellular
;
drug therapy
;
pathology
;
Cell Adhesion
;
drug effects
;
Cell Proliferation
;
drug effects
;
Humans
;
Liver Neoplasms
;
drug therapy
;
pathology
;
Neoplasm Metastasis
;
prevention & control
;
Neovascularization, Pathologic
;
Niacinamide
;
analogs & derivatives
;
Phenylurea Compounds
;
Pyridines
;
therapeutic use
;
Signal Transduction
;
drug effects
10.Prospect of hepatocellular carcinoma in 2008.
Chinese Journal of Hepatology 2009;17(1):7-9
Antineoplastic Agents
;
pharmacology
;
therapeutic use
;
Benzenesulfonates
;
pharmacology
;
therapeutic use
;
Carcinoma, Hepatocellular
;
diagnosis
;
surgery
;
therapy
;
Diagnosis, Differential
;
Humans
;
Liver Neoplasms
;
diagnosis
;
surgery
;
therapy
;
Liver Transplantation
;
Neoplasm Recurrence, Local
;
Neoplasm Staging
;
Niacinamide
;
analogs & derivatives
;
Oligonucleotide Array Sequence Analysis
;
Phenylurea Compounds
;
Polymerase Chain Reaction
;
Pyridines
;
pharmacology
;
therapeutic use
;
Retrospective Studies
;
Survival Rate