High toxicity of sorafenib for recurrent hepatocellular carcinoma after liver transplantation.
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High toxicity of sorafenib for recurrent hepatocellular carcinoma after liver transplantation. / Staufer, Katharina; Fischer, Lutz; Seegers, Barbara; Vettorazzi, Eik; Nashan, Björn; Sterneck, Martina.
In: TRANSPL INT, Vol. 25, No. 11, 11, 2012, p. 1158-1164.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - High toxicity of sorafenib for recurrent hepatocellular carcinoma after liver transplantation.
AU - Staufer, Katharina
AU - Fischer, Lutz
AU - Seegers, Barbara
AU - Vettorazzi, Eik
AU - Nashan, Björn
AU - Sterneck, Martina
PY - 2012
Y1 - 2012
N2 - Treatment options of recurrent hepatocellular carcinoma (HCC) after liver transplantation are limited and data on systemic compounds for advanced tumor stages in transplant recipients are sparse. We retrospectively analyzed the toxicity, tolerability, and efficacy of sorafenib in combination with mTOR inhibitors (mTORi), or calcineurin inhibitors (CNI) in transplant recipients with recurrent HCC. In total, 20 of 92 patients transplanted for HCC within a 10-year time period, experienced tumor recurrence. In case of ineligibility for other treatment options, patients received sorafenib (n?=?13). In addition, CNI were stopped and switched to mTORi in nine patients, whereas CNI were continued in four patients. Grade 3-4 adverse events were observed in 92% of all patients necessitating sorafenib discontinuation in 77%. The most common severe adverse events were acute hepatitis, diarrhea, hand-foot - skin reaction and bone marrow suppression. In patients receiving sorafenib/mTORi one patient achieved partial response, and four achieved stable disease. In this cohort of liver transplant recipients side effects prevented full dosing of sorafenib and necessitated discontinuation of sorafenib in the majority of patients, yet antitumor efficacy seemed promising in combination with mTORi.
AB - Treatment options of recurrent hepatocellular carcinoma (HCC) after liver transplantation are limited and data on systemic compounds for advanced tumor stages in transplant recipients are sparse. We retrospectively analyzed the toxicity, tolerability, and efficacy of sorafenib in combination with mTOR inhibitors (mTORi), or calcineurin inhibitors (CNI) in transplant recipients with recurrent HCC. In total, 20 of 92 patients transplanted for HCC within a 10-year time period, experienced tumor recurrence. In case of ineligibility for other treatment options, patients received sorafenib (n?=?13). In addition, CNI were stopped and switched to mTORi in nine patients, whereas CNI were continued in four patients. Grade 3-4 adverse events were observed in 92% of all patients necessitating sorafenib discontinuation in 77%. The most common severe adverse events were acute hepatitis, diarrhea, hand-foot - skin reaction and bone marrow suppression. In patients receiving sorafenib/mTORi one patient achieved partial response, and four achieved stable disease. In this cohort of liver transplant recipients side effects prevented full dosing of sorafenib and necessitated discontinuation of sorafenib in the majority of patients, yet antitumor efficacy seemed promising in combination with mTORi.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Treatment Outcome
KW - Retrospective Studies
KW - Recurrence
KW - Lung Neoplasms/drug therapy/secondary
KW - TOR Serine-Threonine Kinases/antagonists & inhibitors
KW - Calcineurin/antagonists & inhibitors
KW - Antineoplastic Agents/adverse effects
KW - Benzenesulfonates/adverse effects
KW - Bone Neoplasms/drug therapy/secondary
KW - Carcinoma, Hepatocellular/drug therapy/mortality/pathology
KW - Liver Neoplasms/drug therapy/mortality/pathology/secondary
KW - Liver Transplantation
KW - Protein Kinase Inhibitors/adverse effects
KW - Pyridines/adverse effects
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Treatment Outcome
KW - Retrospective Studies
KW - Recurrence
KW - Lung Neoplasms/drug therapy/secondary
KW - TOR Serine-Threonine Kinases/antagonists & inhibitors
KW - Calcineurin/antagonists & inhibitors
KW - Antineoplastic Agents/adverse effects
KW - Benzenesulfonates/adverse effects
KW - Bone Neoplasms/drug therapy/secondary
KW - Carcinoma, Hepatocellular/drug therapy/mortality/pathology
KW - Liver Neoplasms/drug therapy/mortality/pathology/secondary
KW - Liver Transplantation
KW - Protein Kinase Inhibitors/adverse effects
KW - Pyridines/adverse effects
M3 - SCORING: Journal article
VL - 25
SP - 1158
EP - 1164
JO - TRANSPL INT
JF - TRANSPL INT
SN - 0934-0874
IS - 11
M1 - 11
ER -
