Neo-Adjuvant Use of Sorafenib for Hepatocellular Carcinoma Awaiting Liver Transplantation.
Kate Minoux, Guillaume Lassailly, Massih Ningarhari, Henri Lubret, Medhi El Amrani, Valérie Canva, Stéphanie Truant, Philippe Mathurin, Alexandre Louvet, Gilles Lebuffe, Odile Goria, Eric Nguyen-Khac, Emmanuel Boleslawski, Sebastien Dharancy
Journal: Transplant international : official journal of the European Society for Organ Transplantation
2022;35():10569
PMID: 36438781
Abstract
["Data on efficacy and safety of sorafenib in a neoadjuvant setting for HCC awaiting liver transplantation (LT) are heterogeneous and scarce. We aimed to investigate the trajectory of patients treated with sorafenib while awaiting LT. All patients listed for HCC and treated with sorafenib were included in a monocentric observational study. A clinical and biological evaluation was performed every month. Radiological tumor response evaluation was realized every 3\u00a0months on the waiting list and every 6\u00a0months after LT. Among 327 patients listed for HCC, 62 (19%) were treated with Sorafenib. Sorafenib was initiated for HCC progression after loco-regional therapy (LRT) in 50% of cases and for impossibility of LRT in 50% of cases. The mean duration of treatment was 6\u00a0months. Thirty six patients (58%) dropped-out for tumor progression and 26 (42%) patients were transplanted. The 5-year overall and recurrent-free survival after LT was 77% and 48% respectively. Patients treated for impossibility of LRT had acceptable 5-year intention-to-treat overall and post-LT survivals. Conversely, patients treated for HCC progression presented high dropout rate and low intention-to-treat survival. Our results suggest that it is very questionable in terms of utility that patients treated for HCC progression should even be kept listed once the tumor progression has been observed.",{"copyright":"Copyright \u00a9 2022 Minoux, Lassailly, Ningarhari, Lubret, El Amrani, Canva, Truant, Mathurin, Louvet, Lebuffe, Goria, Nguyen-Khac, Boleslawski and Dharancy."}]
Address:
CHU Lille, Department of Hepatogastroenterology, Lille, France.; INSERM U995, University of Lille, Lille, France.; CHU Lille, Department of Digestive Surgery and Transplantation, University of Lille, Lille, France.; CHU Lille, Department of Anesthesiology, Resuscitation, and Critical Care Anesthesiology, University of Lille, Lille, France.; CHU Rouen, Department of Hepatogastroenterology, Hôpital Charles Nicolle, Rouen, France.; CHU Amiens-Picardie, Hôpital Sud, Department of Hepatogastroenterology, Amiens, France.; CHU Amiens, Centre Universitaire de Recherche en Santé (CURS), Université de Picardie-Jules-Verne (UPJV), Groupe de Recherche sur l'alcool et les Pharmacodépendances (GRAP), Inserm U1247, Amiens, France.
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