Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.

Bolondi, L., Craxi, A., Trevisani, F., Daniele, B., Di Costanzo, G., Fagiuoli, S., et al. (2014). Refining sorafenib therapy: lessons from clinical practice. FUTURE ONCOLOGY, 11(3), 449-465 [10.2217/FON.14.261].

Refining sorafenib therapy: lessons from clinical practice

SPANDONARO, FEDERICO;
2014-01-01

Abstract

Understanding the best use of sorafenib is essential in order to maximize clinical benefit in hepatocellular carcinoma. Based on Phase III and noninterventional study data, as well as our extensive experience, we discuss dose modification in order to manage adverse events, disease response evaluation and how to maximize treatment benefit. Sorafenib should be initiated at the approved dose (400 mg twice daily) and reduced/interrupted as appropriate in order to manage adverse events. Dose modification should be considered before discontinuation. Appropriate tumor response assessment is critical. Focusing on radiologic response may result in premature sorafenib discontinuation; symptomatic progression should also be considered. If second-line therapies or trials are unavailable, continuing sorafenib beyond radiologic progression may provide a clinical benefit. Our recommendations enable the maximization of treatment duration, and hence clinical benefit, for patients.
Pubblicato
Rilevanza internazionale
Articolo
Sì, ma tipo non specificato
Settore SECS-P/06 - Economia Applicata
English
adverse event management; child–Pugh B; dose modification; elderly hepatocellular carcinoma; mRECIST; postprogression treatment; eal-world data; response assessment; sorafenib
Bolondi, L., Craxi, A., Trevisani, F., Daniele, B., Di Costanzo, G., Fagiuoli, S., et al. (2014). Refining sorafenib therapy: lessons from clinical practice. FUTURE ONCOLOGY, 11(3), 449-465 [10.2217/FON.14.261].
Bolondi, L; Craxi, A; Trevisani, F; Daniele, B; Di Costanzo, G; Fagiuoli, S; Cammà, C; Bruzzi, P; Danesi, R; Spandonaro, F; Boni, C; Santoro, A; Colombo, M
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2108/126049
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