Sorafenib Plus Selective Internal Radiation Therapy (SIRT) Improves Survival for Patients with Liver Cancer

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According to a new study published in the journal PLOS ONE, patients with advanced hepatocellular carcinoma (HCC) who are ineligible for surgery may benefit from combined therapy of sorafenib and selective internal radiation therapy (SIRT).


In the multicenter, phase 2 clinical study conducted in Asia, patients with inoperable HCC were started on SIRT using SIR-Spheres microspheres that contain yttrium-90. The microspheres provide short range high energy radiation therapy. Then, patients are given sorafenib, a tyrosine kinase inhibitor, 14 days later.


Researchers found that the combination therapy improved median overall survival by 20.3 months for patients with intermediate stage HCC and 8.6 months for those with advanced liver cancer. In addition, researchers observed a median time to progression of 15.2 months for those with locally advanced HCC and 9 months for patients with advanced liver cancer. Furthermore, the study showed that patients with locally advanced HCC who undergo combination therapy may be downstaged to possibly receive curative therapy.


In light of the results of this phase 2 study, a phase 3 multicenter study has begun to further study the effect SIRT and sorafenib combination therapy and to determine whether it could potentially be first-line treatment for patients with advanced HCC.

Safety and Efficacy Sorafenib Treatment for Hepatocellular Carcinoma Among Age Groups
HCC may benefit from combined therapy of sorafenib and selective internal radiation therapy.

The mature results from a trial conducted by the Asia-Pacific Hepatocellular Carcinoma Trials Group led by the National Cancer Centre Singapore (NCCS) and Singapore General Hospital (SGH) have shown that patients who suffer from inoperable advanced hepatocellular carcinoma (HCC) may have a chance to live significantly longer by using a combined therapy.

The multi-centre phase II clinical trial was conducted at four Asia Pacific tertiary medical centres to evaluate the efficacy of combining two existing treatment modalities, Sorafenib and Selective Internal Radiation Therapy (SIRT). The combination therapy involves starting patients on SIRT using SIR-Spheres microspheres, a medical device that contains radioactive microspheres labeled with yttrium-90 for short range high energy radiation therapy, followed by systemic therapy with an oral chemotherapy drug, Sorafenib, 14 days later.

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