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CALOGERO CAMMA'

Refining sorafenib therapy: Lessons from clinical practice

  • Autori: Bolondi L.; Craxi A.; Trevisani F.; Daniele B.; Di Costanzo G.G.; Fagiuoli S.; Cammà Calogero.; Bruzzi P.; Danesi R.; Spandonaro F.; Boni C.; Santoro A.; Colombo M.
  • Anno di pubblicazione: 2015
  • Tipologia: Articolo in rivista
  • Parole Chiave: adverse event management; Child-Pugh B; dose modification; elderly; hepatocellular carcinoma; mRECIST; postprogression treatment; real-world data; response assessment; sorafenib; Age Factors; Antineoplastic Agents; Carcinoma, Hepatocellular; Clinical Trials as Topic; Combined Modality Therapy; Disease Progression; Humans; Liver Neoplasms; Niacinamide; Phenylurea Compounds; Prognosis; Protein Kinase Inhibitors; Retreatment; Sorafenib; Treatment Outcome
  • OA Link: http://hdl.handle.net/10447/401769

Abstract

Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.