Reduced-Dose Sorafenib Effective and Economical in Hepatocellular Carcinoma

Share this content:
Patients taking a smaller initial dose of sorafenibwere also less likely to discontinue treatment due to gastrointestinal AEs.
Patients taking a smaller initial dose of sorafenibwere also less likely to discontinue treatment due to gastrointestinal AEs.

Reduced initial sorafenib doses in patients with hepatocellular carcinoma (HCC) may decrease cost of therapy, pill burden, rates of discontinuation due to treatment-related adverse events (AEs), and have a noninferior overall survival (OS) rate compared with the standard dose, according to a study published in The Journal of Clinical Oncology.

For this study, investigators retrospectively assessed 4903 patients with hepatocellular carcinoma who received sorafenib. Sixty-three percent (3094) received the standard starting dose of 800 mg daily and 37% (1809) received reduced doses.


Median overall survival was lower in patients who received sorafenib at a reduced initial dose compared with those who received the standard dose (200 days vs 233 days; hazard ratio [HR], 1.10). However, after propensity score matching and adjusting for potential confounders, no significant difference in OS was observed (adjusted HR, 0.92; 95% CI, 0.83-1.01), which was significantly below the noninferiority margin (P <.001).

The reduced-dose arm was prescribed fewer tablets (median, 180 tablets) compared with the standard-dose arm (276 tablets; P <.001), and had much lower costs ($5636 vs $8661; P <.001).

Patients were also less likely to discontinue treatment due to gastrointestinal AEs (8.7% vs 10.8%; P =.047).

The study authors conclude by saying that the findings “suggest that the initiation of sorafenib at a reduced dosage may be a safe and reasonable strategy for some patients with HCC.”

Reference

1. Reiss KA, Yu S, Mamtani R, et al. Starting dose of sorafenib for the treatment of hepatocellular carcinoma: a retrospective, multi-institutional study [published online September 5, 2017]. J Clin Oncol. doi: 10.1200/JCO.2017.73.8245

You must be a registered member of ONA to post a comment.

Sign Up for Free e-newsletters

Regimen and Drug Listings

GET FULL LISTINGS OF TREATMENT Regimens and Drug INFORMATION

Bone Cancer Regimens Drugs
Brain Cancer Regimens Drugs
Breast Cancer Regimens Drugs
Endocrine Cancer Regimens Drugs
Gastrointestinal Cancer Regimens Drugs
Genitourinary Cancer Regimens Drugs
Gynecologic Cancer Regimens Drugs
Head and Neck Cancer Regimens Drugs
Hematologic Cancer Regimens Drugs
Lung Cancer Regimens Drugs
Other Cancers Regimens
Rare Cancers Regimens
Skin Cancer Regimens Drugs