Unresectable Hepatocellular Carcinoma and Prognostic Factors of Sorafenib Treatment: A Real-Life Experience

ABS TRACT Objective: Sorafenib is the first targeted therapy for patients with advanced hepatocellular carcinoma (HCC). This multicenter study primarily aimed to assess real-life experiences of sorafenib in patients with advanced HCC in Türkiye and to determine the prognostic factors. Material and Methods: Patients treated with sorafenib for HCC treatment were included in a retrospective collection of demographic, clinical, and laboratory data. Overall survival (OS) and progression-free survival (PFS), safety data, and prognostic factors were analyzed. Results: A total of 147 patients receiving sorafenib from six tertiary oncology centers were included. Approximately 88.4% and 11.6% of patients were Child-Pugh (CP) classes A and B, respectively. The median PFS was 5.1 (95% CI, 4.3 to 5.9) and 2.9 months (95% CI, 2.3 to 3.5), and OS was 9.8 (95% CI, 6.4 to 13.2) and 5.3 months (95% CI, 4.1 to 6.5) in patients with CP-A and CP-B, respectively. There was a difference in OS between CP-A and B (p=<0.001). The most common adverse event was diarrhea (19.7%, Grade 1-2; 6.8%, Grade 3). The eastern cooperative oncology group (ECOG) performance score, CP score, neutrophil-lymphocyte ratio (NLR), and alpha-fetoprotein (AFP) values were found to be independent prognostic factors. Conclusion: OS and PFS were similar in routine clinical practice compared to Phase III pivotal SHARP and Asia-Pacific trials. The median survival was longer in those with a better ECOG performance score, CP-A, and lower NLR and AFP levels.