Development of hypertension within 2 weeks of initiation of sorafenib for advanced hepatocellular carcinoma is a predictor of efficacy

• DOI: 10.1007/s10147-014-0691-5
• Publication Date: 2014-04-17T02:40:33Z
• Authors: Noriyuki Akutsu; Shigeru Sasaki; Hideyasu Takagi; Masayo Motoya; Masahiro Shitani; Mai Igarashi; Daisuke Hirayama; Hideki Wakasugi; Hiroyuki Yamamoto; Hiroyuki Kaneto; Kazuhiko Yonezawa; Atsushi Yawata; Takeya Adachi; Yasuo Hamamoto; Yasuhisa Shinomura
• Keywords: Aged, 80 and over; Male; Niacinamide; Carcinoma, Hepatocellular; Phenylurea Compounds; Liver Neoplasms; Antineoplastic Agents; Middle Aged; Sorafenib; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Hypertension; Disease Progression; Humans; Female; Aged; Retrospective Studies

Sorafenib is an agent that inhibits vascular endothelial growth factor and is associated with onset or worsening of hypertension in some patients. We conducted a retrospective analysis of whether the development of hypertension during sorafenib treatment of advanced hepatocellular carcinoma could be a predictor of anti-cancer efficacy.The study included 38 patients with advanced hepatocellular carcinoma who had received sorafenib for at least 1 month between January 2010 and December 2012. A retrospective analysis of the efficacy of sorafenib was conducted by dividing the patients into two groups-a hypertension group, presenting with grade 2 or higher hypertension according to the Common Terminology Criteria for Adverse Events (CTCTE) version 4.0; and a non-hypertension group, which included all other patients. This study evaluated the occurrence of hypertension within 2 weeks of initiation of therapy in order to avoid any treatment duration bias. Images were evaluated using the modified Response Evaluation Criteria in Solid Tumors. The response rate, time to progression, and overall survival were assessed.Twenty-two patients (58 %) developed grade 2 or higher hypertension within 2 weeks of initiation of therapy. The response rate was significantly higher in the hypertension group. Median time to progression was 153 days in the hypertension group versus 50.5 days in the non-hypertension group, which was significantly longer in the hypertension group. Moreover, median overall survival was 1,329 days in the hypertension group versus 302 days in the non-hypertension group, which was significantly longer in the hypertension group.Hypertension within 2 weeks of initiation of therapy may be a predictor of the anti-cancer efficacy of sorafenib when used for the treatment of advanced hepatocellular carcinoma.