Treatment outcomes of advanced hepatocellular carcinoma in real-life practice: Chemotherapy versus multikinase inhibitors
Issued Date
2023-02-01
Resource Type
eISSN
20457634
Scopus ID
2-s2.0-85137516771
Pubmed ID
36082831
Journal Title
Cancer Medicine
Volume
12
Issue
3
Start Page
3046
End Page
3053
Rights Holder(s)
SCOPUS
Bibliographic Citation
Cancer Medicine Vol.12 No.3 (2023) , 3046-3053
Suggested Citation
Oranratnachai S., Rattanasiri S., Sirachainan E., Tansawet A., Raunroadroong N., McKay G.J., Attia J., Thakkinstian A. Treatment outcomes of advanced hepatocellular carcinoma in real-life practice: Chemotherapy versus multikinase inhibitors. Cancer Medicine Vol.12 No.3 (2023) , 3046-3053. 3053. doi:10.1002/cam4.5224 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/82691
Title
Treatment outcomes of advanced hepatocellular carcinoma in real-life practice: Chemotherapy versus multikinase inhibitors
Other Contributor(s)
Abstract
Background: Multikinase inhibitors (MKIs) represent the main treatment options for advanced hepatocellular carcinoma (aHCC). However, accessibility in developing countries is limited. A chemotherapy, Fluorouracil and Oxaliplatin (FOLFOX), offers a less expensive treatment. Therefore, this study sought to compare the clinical effectiveness of FOLFOX with Sorafenib as a first-line treatment for aHCC in real-life practice. Methods: A retrospective aHCC cohort from four Thai hospitals was investigated for patients who received FOLFOX or Sorafenib between 2013–2019. Multiple imputation by chained equations addressed missing covariate data in a treatment effect model using Weight-adjusted-censoring inverse-probability-weighted regression adjustment; overall survival (OS) and progression-free survival (PFS) were estimated. Results: A total of 504 patients were included, (Sorafenib [n = 382] and FOLFOX [n = 122]). The treatment effect model estimated a median OS for Sorafenib and FOLFOX of 11.38 and 8.22 months, representing a significantly shorter OS (95% confidence interval) of −3.16 (−6.21, −0.11) months for FOLFOX, p = 0.042. A significant shorter median PFS of FOLFOX to Sorafenib of −2.13 (−3.03, −1.24) months, p < 0.001, was reported. Conclusion: Despite significantly shorter median OS and PFS than Sorafenib, FOLFOX still extended OS by 8.22 months. This evidence may offer clinical utility to physicians considering treatment options for aHCC in low resource settings.