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Original Article

Efficacy of sorafenib therapy in patients with advanced

hepatocellular carcinoma in Indian population

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Alit Abraham , Charumathi Purushothaman , Dhanya Damien , Jackson James ,
Prudence Attilade Rodrigues , Gursharan Singh 2
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1 Department of Pharmacy Practice, P.S.G College of Pharmacy, Coimbatore 641004, Tamil Nadu, India.
2 Department of Hepatobiliary and Liver Transplantation Surgery, P.S.G Hospitals, Coimbatore 641004, Tamil Nadu, India.
ABSTRACT
Aim: Hepatocellular carcinoma (HCC) is the fourth most common type of cancer and the third leading cause of
cancer-related mortality. Sorafenib is an oral multikinase inhibitor that is used for unresectable advanced HCC. It
is only approved systemic therapy for advanced HCC. Methods: A retrospective prospective study conducted in a
multispeciality hospital with 50 patients who received sorafenib. The primary outcome of the study was to find out
the survival rate of patients treated with sorafenib. The secondary outcome of the study was to explore the efficacy
and safety of sorafenib in a progression of HCC. Results: The median overall survival in the Indian population
was found as 114 days (3.8 months) after sorafenib therapy. The efficacy of the drug sorafenib was assessed
by the survival days which were based on the changes in laboratory values such as haematological and clinical
biochemistry. The adverse drug reaction documented in this study was vomiting, abdominal pain; fatigue; anorexia;
hyperbilirubinemia; diarrhoea; hand-foot syndrome; rash; rectal bleeding; insomnia; constipation; thrombocytopenia
and abdominal discomfort. Conclusion: Sorafenib improves the overall survival of the patients with advanced HCC
in Indian population up to 3.8 months. It is a safe and effective treatment for patients with advanced HCC in Indian
population. The survival of patients was found to be depended on the liver function.
Key words: Hepatocellular carcinoma; sorafenib; Indian population

Corresponding Author:
Dr. Alit Abraham, Department of Pharmacy Practice, P.S.G College of Pharmacy, Coimbatore 641004, Tamil Nadu, India.
E-mail: alit.abraham@gmail.com
Received: 17-02-2016; Accepted: 20-07-2016

INTRODUCTION the current decades. The main cause of HCC is cirrhosis,
[2]
hepatitis B virus infection, chronic hepatitis C virus
Hepatocellular carcinoma (HCC) is the fourth most common infection, and alcohol abuse and aflatoxin exposure. Other
type of cancer and the third leading cause of cancer-related risk factors include non-alcoholic steatohepatitis, alcohol
[1]
mortality. Approximately 4% of new cases diagnosed abuse, obesity, fatty liver, hemochromatosis, Wilson’s
worldwide. About 782,000 new cases are diagnosed in disease; type 2 diabetes mellitus, haemophilia alpha 1
2012. In India, the age-adjusted incidence rate of HCC antitrypsin deficiency, autoimmune hepatitis, smoking and
for men ranges from 0.7-7.5 and for women 0.2-2.2 per tobacco, and diabetes. Advanced HCC is the multinodular/
[3]
100,000 of population per year. The male: female ratio for unresectable HCC, HCC with extrahepatic spread or HCC
HCC in India is 4:1. The age-standardized mortality rate [4]
for HCC in India for men is 6.8/100,000 and for women with vascular invasion.
is 5.1/100,000. The incidence of HCC is increasing in
India. India is one of the developing countries among the The treatment options for HCC include surgical resection,
worldwide and the incidence of HCC is being increased in liver transplantation, transarterial chemoembolization or
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How to cite this article: Abraham A, Purushothaman C, Damien
DOI: D, James J, Rodrigues PA, Singh G. Efficacy of sorafenib therapy
10.20517/2394-5079.2016.03 in patients with advanced hepatocellular carcinoma in Indian
population. Hepatoma Res 2016;2:224-8.
224 © 2016 Hepatoma Research | Published by OAE Publishing Inc.