Because hepatocellular carcinoma occurs most frequently in patients who are approximately 70 years old, researchers set out to evaluate the safety of sorafenib, the standard of care for patients with advanced hepatocellular carcinoma, in older patients.
The researchers conducted a retrospective analysis from a single institution’s data regarding patients with hepatocellular carcinoma who received sorafenib treatment. The researcher compared the data relating to the safety and effectiveness of sorafenib treatment across age groups. The researchers analyzed the data of 129 patients.
Of these patients, 78 were older than age 70 (60.5%), 51 patients were age 70 or younger (39.5%). The researchers found that the occurrence of dose reduction was comparable between the 2 groups of patients (48.7% vs. 58.8%, respectively). The occurrence of sever toxicities was also comparable (41% vs. 51%, respectively).
The same was true for the rate of hospitalization (9% vs. 13.7%, respectively). Bleeding and asthenia, though, were more common in older adults (the group over age 70). The researchers identified a trend is less treatment interruption in the younger patients compared with the patients over age 70 (25.6% vs. 39.2%, respectively). The younger patients also saw a significant decrease in the rate of treatment discontinuation due to treatment toxicity (24.4% vs. 45.1%, respectively).
Interestingly, the median progression-free survival rate was 5.6 in both groups of patients and the median overall survival was longer in the older age group compared with younger age group (12.6 months vs. 9.6 months, respectively). The researchers concluded that there was not a big distinction between an older or younger patient being treated with sorafenib in terms of treatment safety or efficacy.
However, oncologists should conduct careful baseline evaluation and prepare for toxicity management and discussions regarding antiplatelet therapy discontinuation and caution in PS1 patients, in particular.
The authors aimed to evaluate safety and efficacy of sorafenib in the elderly population. Sorafenib showed similar results in terms of safety and efficacy in the elderly and younger HCC populations. Careful baseline evaluation is needed for patient’s selection in the elderly population, including discussion about antiplatelet therapy discontinuation and caution in PS1 patients, as well as active management of toxicity.