Efficacy and safety of transarterial chemoembolization plus sorafenib in patients with recurrent hepatocellular carcinoma after liver transplantation

Xia Zhang; Lirong Cai; Jian Fang; Fengsui Chen; Fan Pan; Kun Zhang; Qian Huang; Yuju Huang; Dongliang Li; Lizhi Lv; Man Chen; Ruiying Yan; Yanhua Lai; Yonghai Peng; Zhixian Wu

doi:10.3389/fonc.2022.1101351

Efficacy and safety of transarterial chemoembolization plus sorafenib in patients with recurrent hepatocellular carcinoma after liver transplantation

Front Oncol. 2023 Jan 13:12:1101351. doi: 10.3389/fonc.2022.1101351. eCollection 2022.

Authors

Xia Zhang¹, Lirong Cai¹, Jian Fang², Fengsui Chen¹, Fan Pan³, Kun Zhang⁴, Qian Huang³, Yuju Huang¹, Dongliang Li¹, Lizhi Lv³, Man Chen¹, Ruiying Yan¹, Yanhua Lai⁵, Yonghai Peng⁶, Zhixian Wu¹

Affiliations

¹ Department of Hepatobiliary Disease, the 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China.
² Department of Hepatobiliary Disease, The Third People's Hospital of Fujian University of Traditional Chinese Medicine, Fuzhou, China.
³ Department of Hepatobiliary Surgery, the 900th Hospital of Joint Logistics Support Force, Fujian Medical University, Fuzhou, China.
⁴ Department of Hepatobiliary Surgery, Xiang'an Hospital, Xiamen University, Xiamen, China.
⁵ Department of Transplantation, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China.
⁶ Department of Oncology, the 900th Hospital of Joint Logistics Support Force, Fujian Medica University, Fuzhou, China.

Abstract

Objectives: To explore the benefit and safety of transarterial chemoembolization (TACE) in combination with sorafenib in patients with recurrent hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT).

Methods: In this multi-center retrospective study, 106 patients with recurrent HCC after OLT were included. Fifty-two patients were treated with TACE plus sorafenib (TS group) and 54 were treated with TACE alone (TC group). Primary and secondary endpoints including overall survival (OS) and progression-free survival (PFS), and safety were assessed.

Results: The median OS (17 vs 10 months, P=0.035) and PFS (12 vs 6 months, P=0.004) in the TS group were longer than those in the TC group. On multivariate analysis, BCLC stage (HR [hazard ratio]=0.73 [95% CI, 0.27-0.99], P=0.036) and sorafenib medication (HR=2.26 [95% CI, 1.35-3.69], P=0.01) were identified as independent prognostic risk factors for OS. No severe adverse events related to sorafenib were noted in the TS group. Four patients discontinued sorafenib due to intolerance.

Conclusion: TACE in combination with sorafenib is a feasible regimen to improve the survival with mild toxicity in patients with recurrent HCC after OLT.

Keywords: hepatocellular carcinoma; liver transplantation; overall survival; sorafenib; transarterial chemoembolization.

Grants and funding

The authors are grateful for the support of the Fujian Provincial Social Development Guiding Key Project (2016Y0068); the Science and Technology Innovation Joint Fund Project of Fujian (2019Y9044); the Natural Science Fund of Fujian Province (2020J011131); Hospital-Level Funds of 900th Hospital (2018Q07); the National Natural Science Foundation of China (81572452); the Gandanxiangzhao Fund of the Henan Provincial Charity Federation.