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Development of hypertension within 2 weeks of initiation of sorafenib for advanced hepatocellular carcinoma is a predictor of efficacy

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Abstract

Background

Sorafenib is an agent that inhibits vascular endothelial growth factor and is associated with onset or worsening of hypertension in some patients. We conducted a retrospective analysis of whether the development of hypertension during sorafenib treatment of advanced hepatocellular carcinoma could be a predictor of anti-cancer efficacy.

Methods

The study included 38 patients with advanced hepatocellular carcinoma who had received sorafenib for at least 1 month between January 2010 and December 2012. A retrospective analysis of the efficacy of sorafenib was conducted by dividing the patients into two groups—a hypertension group, presenting with grade 2 or higher hypertension according to the Common Terminology Criteria for Adverse Events (CTCTE) version 4.0; and a non-hypertension group, which included all other patients. This study evaluated the occurrence of hypertension within 2 weeks of initiation of therapy in order to avoid any treatment duration bias. Images were evaluated using the modified Response Evaluation Criteria in Solid Tumors. The response rate, time to progression, and overall survival were assessed.

Results

Twenty-two patients (58 %) developed grade 2 or higher hypertension within 2 weeks of initiation of therapy. The response rate was significantly higher in the hypertension group. Median time to progression was 153 days in the hypertension group versus 50.5 days in the non-hypertension group, which was significantly longer in the hypertension group. Moreover, median overall survival was 1,329 days in the hypertension group versus 302 days in the non-hypertension group, which was significantly longer in the hypertension group.

Conclusions

Hypertension within 2 weeks of initiation of therapy may be a predictor of the anti-cancer efficacy of sorafenib when used for the treatment of advanced hepatocellular carcinoma.

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Acknowledgments

We thank all the gastroenterologists who took part in this study: Dr. T Kobayashi, Dr. H Yamauchi, and Dr. G Sudoh at Hakodate Goryoukaku Hospital, Dr. H Isshiki, Dr. A Itoh, Dr. I Yamamoto, Dr. K Ishigami, and Dr. H Sasaki at Muroran City General Hospital, Dr. S Kanno, and Dr. K Honma, at Kushiro City General Hospital, Dr. K Mitsuhashi at Otaru City General Hospital, Dr. Y Matsunaga at Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University.

Conflict of interest

Shigeru Sasaki received remuneration for the lecture from Bayer Yakuhin Ltd (Osaka, Japan).

Author information

Authors and Affiliations

  1. Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University, S-1, W-16, Chuo-ku, Sapporo, 060-8543, Japan

    Noriyuki Akutsu, Shigeru Sasaki, Hideyasu Takagi, Masayo Motoya, Masahiro Shitani, Mai Igarashi, Daisuke Hirayama, Hideki Wakasugi, Hiroyuki Yamamoto & Yasuhisa Shinomura

  2. Department of Gastroenterology, Muroran City General Hospital, 3-8-1 Yamatecho, Muroran, Hokkaido, 051-8512, Japan

    Hiroyuki Kaneto

  3. Department of Gastroenterology, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro, Hokkaido, 085-0822, Japan

    Kazuhiko Yonezawa

  4. Department of Gastroenterology, Hakodate Goryoukaku Hospital, 38-3 Goryoukaku, Hakodate, Hokkaido, 040-8611, Japan

    Atsushi Yawata

  5. Department of Gastroenterology, Otaru City General Hospital, 1-2-1 Wakamatsu, Otaru, Hokkaido, 047-8550, Japan

    Takeya Adachi

  6. Division of Gastroenterology, Department of Internal Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo, 160-8582, Japan

    Yasuo Hamamoto

Authors
  1. Noriyuki Akutsu
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  2. Shigeru Sasaki
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  3. Hideyasu Takagi
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  4. Masayo Motoya
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  5. Masahiro Shitani
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  6. Mai Igarashi
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  7. Daisuke Hirayama
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  8. Hideki Wakasugi
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  9. Hiroyuki Yamamoto
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  10. Hiroyuki Kaneto
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  11. Kazuhiko Yonezawa
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  12. Atsushi Yawata
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  13. Takeya Adachi
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  14. Yasuo Hamamoto
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  15. Yasuhisa Shinomura
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Corresponding author

Correspondence to Noriyuki Akutsu.

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Akutsu, N., Sasaki, S., Takagi, H. et al. Development of hypertension within 2 weeks of initiation of sorafenib for advanced hepatocellular carcinoma is a predictor of efficacy. Int J Clin Oncol 20, 105–110 (2015). https://doi.org/10.1007/s10147-014-0691-5

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  • DOI: https://doi.org/10.1007/s10147-014-0691-5

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