Efficacy of sorafenib after liver transplantation in patients with primary hepatic carcinoma exceeding the Milan criteria: a preliminary study.
Huang L, Li G. M, et al.Onco Targets and Therapy 2012; 5: 457-462.
Aims
To determine the efficacy of sorafenib in preventing and/or treating the recurrence of a tumour in patients with primary hepatic carcinoma, after transplantation.
Interventions
Patients were treated orally with sorafenib 400mg bid, one month after surgery. Dosage was reduced to 200mg bid or discontinued when intolerable toxicity occurred. This was compared with capecitabine 1500mg bid, administered for two weeks followed by a two week rest interval in each cycle.
Participants
30 adult liver transplant recipients with primary hepatic carcinoma exceeding the Milan criteria.
Outcomes
Tumour recurrence, survival rates and mean survival time.
Follow-up
12 months.
CET Conclusions
Sorafenib (Nexavar) is a small molecule inhibitor of several tyrosine protein kinases and Raf kinases and was compared with Capecitabine, an inhibitor of DNA synthesis, in recipients of liver transplants for advanced hepatocellular cancer. The authors suggest that Sorefenib may reduce recurrence and prolong patient survival. However it should be noted that NICE have not approved the use of sorafenib for advanced hepatic carcinoma in the UK on the basis that the randomised trial results showed only a very modest benefit. The authors do not state whether these were cadaver liver donors and whether executed prisoners were used. That these results warrant a further study as suggested by the authors is in my opinion doubtful.
Data analysis
Per protocol analysis
Trial registration
Not reported.