Survival Rates at 1 Year Were Higher in TACE-vs Sorafenib-Treated Patients With Hepatocellular Carcinoma: Presented at ASCO Quality Care

Source - DGDispatch 

Survival Rates at 1 Year Were Higher in TACE-vs Sorafenib-Treated Patients With Hepatocellular Carcinoma: Presented at ASCO Quality Care

By Cathy Yarbrough

SAN DIEGO -- December 4, 2012 -- Patients with hepatocellular carcinoma (HCC) in the European Union and United States who were treated with arterial chemotherapy infusion and chemoembolization of the liver (TACE) had statistically significant higher 1-year survival rates than patients whose first-line therapy was sorafenib, according to a study presented here at the American Society of Clinical Oncology (ASCO)'s inaugural 2012 Quality Care Symposium.

In Asia, however, 1-year survival did not differ between TACE- and sorafenib-treated patients, said Glen I. Misek, Abbott Laboratories, Abbott Park, Illinois, on November 30.

Misek and colleagues analysed a global database of 4,000 patients with HCC to understand differences in overall survival (OS) and progression-free survival that could be the result of patient demographics such as ethnicity and comorbidities such as hepatitis B or C and alcohol-induced cirrhosis. Effectiveness of treatments according to the stage of disease was also examined.

HCC is the sixth leading cancer, with a global incidence of >700,000 individuals. Although new drugs against HCC are now available, prognosis is poor in that the 5-year survival is only 11%, Misek said.

The researchers determined that 5-year survival rates were comparable across geographic regions. However, 1-year survival of patients with HCC was significantly lower in China and Korea than in the United States and the European Union. China and Korea's lower survival may reflect the region's different treatment practices.

A surprising result of the analysis, according to Misek, was that concomitant conditions of hepatitis and cirrhosis did not affect differences in 1-year survival regardless of sorafenib use. Compared with Asian patients, US and EU patients tended to have more concomitant comorbidities such as hypertension, diabetes, asthma, kidney disease, and depression/anxiety.

An expected finding was that 1-year survival rates of patients with HCC stages III and IV, versus stage I/II, were significantly reduced. Similarly, according to Child-Pugh (CP) classifications, the survival rates of patients with CP-C (most advanced) were significantly lower than patients with CP-A.

Misek said that because sorafenib therapy did not affect OS of patients with stage IV HCC, the disease's impact may be more effectively reduced by increased screening and detection and treatment of patients at high risk of the disease than by expanding the use of the drug in patients with late-stage disease.

Because brief sorafenib therapy regimens may improve a patient's quality of life and reduce healthcare costs, Misek concluded that prospective indicators to identify patients who could benefit from minimal treatment regimens are needed.

Stratification of groups by type of drug treatment including sorafenib use did not measurably affect OS within geographies.

[Presentation title: Effectiveness of HCC Treatments in Real-World Experience. Abstract 61]