ஐ.எஸ்.எஸ்.என்: 2167-7700
Wontae Cho, Jong Man Kim, Jin Yong Choi, Seung Hwan Lee, Hyung Hwan Moon, Sanghoon Lee, Jae Berm Park, Choon Hyuck David Kwon, Jae-Won Joh, Sung Joo Kim and Suk-Koo Lee
Backgrounds: Sirolimus and sorafenib both have been used in recurrent Hepatocellular Carcinoma (HCC) patients after Liver Transplantation (LT). In the present study, we evaluated the side effects and efficacy of acombination therapy consisting of sirolimus and sorafenib.
Methods: We retrospectively reviewed patients who had recurrent HCC after LT between 2005 and 2012. Toxicity was evaluated by reviewing medical records for each follow-up visit. Efficacy was evaluated according to the modified RECIST guidelines.
Results: A total of 24 patients who received combination therapy were reviewed to evaluate drug toxicity. Side effects included hand-foot syndrome (n=12, 50%), diarrhea (n=7, 29.2%), fatigue (n=2, 8.3%), and alopecia (n=1, 4.2%). Among the 24 patients enrolled in this study, 19 were evaluated for efficacy. A complete response was observed in only 1 case (5.3%), while a partial response was observed in 2 cases (10.5%). Five cases (26.3%) showed disease stabilization. The median overall survival after initiation of the combination therapy was 21.6 months. In comparison, 26 recipients with recurrent HCC received non-combination therapy. The median survival of patients receiving a non-combination therapy was 12.0 months. However, there was no statistically significant difference in patient survival rate between the combination and non-combination therapy groups (P=0.101).
Conclusion: Combination therapy of sorafenib and sirolimus for recurrent HCC LT recipients may be useful for disease management. However, controlled prospective study is needed to further evaluate the safety and efficacy of combined sorafenib and sirolimus therapy.