1. Refining sorafenib therapy: lessons from clinical practice
- Author
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Federico Spandonaro, Luigi Bolondi, Massimo Colombo, Stefano Fagiuoli, Giovan Giuseppe Di Costanzo, Antonio Craxì, Corrado Boni, Romano Danesi, Calogero Cammà, Armando Santoro, Bruno Daniele, Paolo Bruzzi, Franco Trevisani, Bolondi L., Craxi A., Trevisani F., Daniele B., Di Costanzo G.G., Fagiuoli S., Cammà Calogero., Bruzzi P., Danesi R., Spandonaro F., Boni C., Santoro A., Colombo M., L. Bolondi, A. Craxi, F. Trevisani, B. Daniele, G. G. Di, S. Fagiuoli, C. Cammà, P. Bruzzi, R. Danesi, F. Spandonaro, C. Boni, A. Santoro, M. Colombo, Bolondi, L, Craxi, A, Trevisani, F, Daniele, B, Di Costanzo, G, Fagiuoli, S, Camma, C, Bruzzi, P, Danesi, R, Spandonaro, F, Boni, C, Santoro, A, and Colombo, M
- Subjects
Cancer Research ,Settore SECS-P/06 - Economia Applicata ,Antineoplastic Agent ,Age Factor ,Child–Pugh B ,postprogression treatment ,response assessment ,dose modification ,Clinical Trials as Topic ,Liver Neoplasms ,adverse event management ,Age Factors ,Child-Pugh B ,hepatocellular carcinoma ,General Medicine ,Prognosis ,child–Pugh B ,elderly hepatocellular carcinoma ,mRECIST ,eal-world data ,sorafenib ,Combined Modality Therapy ,Clinical Practice ,Treatment Outcome ,Oncology ,Liver Neoplasm ,Hepatocellular carcinoma ,Retreatment ,Disease Progression ,Human ,medicine.drug ,Phenylurea Compound ,Niacinamide ,Sorafenib ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Disease Response ,Prognosi ,elderly, hepatocellular carcinoma ,Protein Kinase Inhibitor ,Antineoplastic Agents ,elderly ,Adverse event management, Child–Pugh B, dose modification, elderly, hepatocellular carcinoma, mRECIST, postprogression treatment, real-world data, response assessment, sorafenib ,medicine ,Humans ,Intensive care medicine ,Adverse effect ,Protein Kinase Inhibitors ,Dose Modification ,real-world data ,business.industry ,Phenylurea Compounds ,medicine.disease ,Discontinuation ,Surgery ,business - Abstract
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.
- Published
- 2015
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