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Topic: Natural Products and Hepatocellular Carcinoma

Can sorafenib be discontinued in hepatocellular carcinoma
Can sorafenib be discontinued in hepatocellular carcinoma
patients with a complete response to treatment?
patients with a complete response to treatment?

Jing Li, Liang Huang, Yi-Qun Yan
Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, China

Address for correspondence:
Prof. Yi-Qun Yan, Department of Hepatic Surgery I, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Changhai
Road, Shanghai 200438, China. E-mail: ehbhyyq@163.com
Received: 18-05-2015, Accepted: 24-06-2015

INTRODUCTION were reported. For patients who have achieved CR, whether
[5]
sorafenib can be discontinued remains unknown.
Sorafenib is a multi-kinase inhibitor that inhibits angiogenesis
by targeting the vascular endothelial growth factor PRESENTATION OF THE HYPOTHESIS
receptor 2 and platelet-derived growth factor receptor
pathways while blocking cell proliferation by targeting the Most cases in which sorafenib was discontinued during the
Ras/mitogen-activated protein kinase signaling pathway. Two course of treatment for HCC resulted from severe adverse
global phase III trials [Sorafenib Hepatocellular Carcinoma events. [1,2] For patients who have achieved CR, we proposed
Assessment Randomized Protocol (SHARP) and Asia-Pacific the concept that sorafenib may be discontinued in CR cases,
[1]
trial ] showed that sorafenib prolonged the survival of taking into consideration the high cost for such patients in
[2]
patients with advanced hepatocellular carcinoma (HCC). The poor societies, particularly those in developing countries
results of these studies were rapidly disseminated worldwide with restrictive coverage for certain pharmaceuticals from
and were enthusiastically accepted by physicians specializing national health insurance systems.
in liver cancer treatment. Based on the positive results of
the SHARP trial, the EU and USA approved sorafenib for SUPPORTIVE OBSERVATION FOR THIS HYPOTHESIS
[1]
advanced HCC in October and November 2007, respectively. AND FUTURE DIRECTIONS
Sorafenib was also approved for patients with unresectable
and metastatic HCC in July 2008 in China, but patients have Recently, a 39-year-old male patient who was diagnosed
to pay the cost by themselves. with HCC (2 cm in diameter) on May 6, 2010 was admitted.
He could not receive radical therapy (hepatic resection or
Thereafter, clinicians studied whether enhanced benefits could radiofrequency ablation) because the tumor was located
be derived from combining sorafenib with other therapeutic very close to the right branch of the portal vein. Therefore,
means. Several studies [3,4] assessed optimal combinations of he received TACE plus sorafenib therapy. One week later,
sorafenib with transarterial chemoembolization (TACE) or he had severe drug-related diarrhea (4-8 times bowel
radiofrequency ablation, as well as the sequence of treatment movement daily). Five weeks after treatment, the tumor
modalities in order to maximize patients’ outcomes. Since was not detected on both computed tomography scan and
then, an increasing number of complete remission (CR) cases
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DOI: How to cite this article: Li J, Huang L, Yan YQ. Can sorafenib be
10.4103/2394-5079.161332 discontinued in hepatocellular carcinoma patients with a complete response
to treatment? Hepatoma Res 2015;1:109-10.

© 2015 Hepatoma Research | Published by Wolters Kluwer - Medknow 109