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Treatment efficacy by hepatic arterial infusion chemotherapy vs. sorafenib after liver-directed concurrent chemoradiotherapy for advanced hepatocellular carcinoma

  • Original Article – Clinical Oncology
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Abstract

Background

We compared the clinical efficacies of hepatic arterial infusion chemotherapy (HAIC) vs. sorafenib as sequential maintenance therapy following liver-directed concurrent chemoradiotherapy (LD-CCRT) for locally advanced-stage hepatocellular carcinoma (HCC).

Methods

Patients undergoing HAIC with 5-fluorouracil and cisplatin (HAIC-maintain group, n = 151) or sorafenib (Sorafenib-maintain group, n = 37) after LD-CCRT were consecutively enrolled. The study endpoints were overall survival (OS), progression-free survival (PFS), and treatment response rates.

Results

The median OS among HAIC-maintain and Sorafenib-maintain groups were 15.9 and 24.3 months (p = 0.287), whereas the median PFS were 8.1 and 9.1 months (p = 0.651), respectively. During the planned treatments, the radiological objective response rate (54.3% vs. 64.9%; p = 0.246), and conversion rate to surgical resection or liver transplantation after successful down-staging (15.9% vs. 18.9%; p = 0.657) were comparable between the HAIC-maintain and Sorafenib-maintain groups. Similar results were found after the inverse probability of treatment weighting and propensity score-matching analyses. Regarding treatment-related adverse events, the HAIC-maintain group showed worse profiles in terms of leukopenia (all grades [p = 0.001] and grades 3 or 4 [p = 0.041]) and hypoalbuminemia (p = 0.001) than the Sorafenib-maintain group.

Conclusions

The overall clinical efficacies between the sequential treatment of HAIC vs. sorafenib after LD-CCRT were comparable for locally advanced HCC.

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Data availability

The datasets generated and analyzed during the current study are not publicly available due to the IRB guidelines but are available from the corresponding author on reasonable request.

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Funding

This research received no funding. Compliance with ethical standards.

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Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Sojung Han, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Seung Up Kim, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han & Beom Kyung Kim

  2. Yonsei Liver Center, Severance Hospital, Yonsei University Health System, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Sojung Han, Hyein Lee, Jae Seung Lee, Hye Won Lee, Jun Yong Park, Seung Up Kim, Do Young Kim, Sang Hoon Ahn & Beom Kyung Kim

  3. Division of Medical Oncology, Department of Internal Medicine, Yonsei Cancer Center, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Hye Jin Choi & Seung-Hoon Beom

  4. Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Hye Rim Kim

  5. Institute of Gastroenterology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Jae Seung Lee, Hye Won Lee, Jun Yong Park, Seung Up Kim, Do Young Kim, Sang Hoon Ahn & Beom Kyung Kim

  6. Department of Radiation Oncology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Jinsil Seong

  7. Department of Radiology, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea

    Jong Yun Won

Authors
  1. Sojung Han
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  2. Hye Jin Choi
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  4. Hye Rim Kim
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  5. Hyein Lee
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Contributions

Conceptualization, SH. and BKK.; methodology, SH, HWL, and BKK, and software, SH, HRK, HL, JSL, HWL, and SUK; validation, SH, JYP, and BKK; formal analysis, SH, HRK, HL, JSL, and DYK; investigation, SH, HWL, and DYK; resources, BKK; data curation, SH, HL, and JSL; writing—original draft preparation, SH, JYW, SUK, JYP, DYK and BKK; writing—review and editing, SH, HJC, SB, HL, JSL SHA, KHH, JS and BKK.; visualization, SH, JYP, and SHA; supervision, BKK; All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Beom Kyung Kim.

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The authors declare that they have no conflict of interests.

Ethics approval

This study protocol was developed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and approved by the Institutional Review Board of our institute (No. 4–2020-0145). The requirement for written informed consent was waived owing to the retrospective design.

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Han, S., Choi, H.J., Beom, SH. et al. Treatment efficacy by hepatic arterial infusion chemotherapy vs. sorafenib after liver-directed concurrent chemoradiotherapy for advanced hepatocellular carcinoma. J Cancer Res Clin Oncol 147, 3123–3133 (2021). https://doi.org/10.1007/s00432-021-03632-4

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