Real-life experience with sorafenib for the treatment of hepatocellular carcinoma in HIV-infected patients

Autors de IIS La Fe

• Marta Montero Alonso

  Autor

• María Jose Galindo Puerto

  Autor

• Maria Angeles Garcia Esparza

  Autor

• Andrea Martinez Deltoro

  Autor

Autors aliens a IIS La Fe

• Merchante, N
• Ibarra, S
• Revollo, B
• Rodriguez-Arrondo, F
• Merino, E
• Delgado-Fernandez, M
• Tellez, F
• Rivero-Juarez, A
• Minguez, C
• Romero-Palacios, A
• Pineda, JA
• GEHEP-002 Study Group

Grups d'Investigació

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

  Investigador establecido

  Marta Montero Alonso

Abstract

Objective:To report the real-life results of sorafenib use in a cohort of HIV-infected patients with hepatocellular carcinoma (HCC).Methods:The GEHEP-002 cohort (ClinicalTrials.gov ID: NCT02785835) has recruited 302 HCC cases diagnosed in HIV-infected patients from 32 centers from Spain. RIS-HEP12 study included 44 (14%) cases that have received at least one dose of sorafenib. The overall survival after the start of treatment was the main efficacy outcome. Permanent discontinuation due to adverse events was the primary safety end point.Results:Reasons for sorafenib use are HCC recurrence after previous curative therapy (n=7), progression following transarterial chemoembolization (n=6) and first treatment against HCC (n=31). Nineteen (43%) patients harbored Child-Pugh B cirrhosis. Barcelona-Clinic Liver Cancer stage was A 3 (7%), B 6 (14%), C 30 (68%) and D 5 (11%). All patients were on antiretroviral therapy (ART). The median (Q1-Q3) duration of sorafenib treatment was 70 (31-158) days. Median survival was 7.2 months, whereas the median (Q1-Q3) duration of overall survival after the start of treatment was 4 (2-9.7) months. Twenty-six (59%) patients had any grade adverse events and 19 (43%) suffered a decompensation. Discontinuation due to adverse events occurred in 17 (38.6%) patients. There were no modifications or discontinuations of ART. CD4(+) cell counts and HIV viral load remained stable.Conclusion:The efficacy of sorafenib under real-life conditions in HIV-infected patients seems lower than that reported in the registration clinical trial. On the contrary, the tolerability of sorafenib appears to be similar to what is seen in patients without HIV infection. Sorafenib does not seem to modify the efficacy of ART.

Keywords

• hepatitis C virus; hepatocellular carcinoma; HIV; liver cirrhosis; sorafenib