Open AccessTreatment outcomes of advanced hepatocellular carcinoma in real‐life practice: Chemotherapy versus multikinase inhibitors
Author(s) -
Oranratnachai Songporn,
Rattanasiri Sasivimol,
Sirachainan Ekaphop,
Tansawet Amarit,
Raunroadroong Nilubol,
McKay Gareth J.,
Attia John,
Thakkinstian Ammarin
Publication year - 2023
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.5224
Subject(s) - folfox , sorafenib , oxaliplatin , medicine , hepatocellular carcinoma , oncology , retrospective cohort study , colorectal cancer , cancer
Background Multikinase inhibitors (MKIs) represent the main treatment options for advanced hepatocellular carcinoma (aHCC). However, accessibility in developing countries is limited. A chemotherapy, Fluorouracil and Oxaliplatin (FOLFOX), offers a less expensive treatment. Therefore, this study sought to compare the clinical effectiveness of FOLFOX with Sorafenib as a first‐line treatment for aHCC in real‐life practice. Methods A retrospective aHCC cohort from four Thai hospitals was investigated for patients who received FOLFOX or Sorafenib between 2013–2019. Multiple imputation by chained equations addressed missing covariate data in a treatment effect model using Weight‐adjusted‐censoring inverse‐probability‐weighted regression adjustment; overall survival (OS) and progression‐free survival (PFS) were estimated. Results A total of 504 patients were included, (Sorafenib [ n = 382] and FOLFOX [ n = 122]). The treatment effect model estimated a median OS for Sorafenib and FOLFOX of 11.38 and 8.22 months, representing a significantly shorter OS (95% confidence interval) of −3.16 (−6.21, −0.11) months for FOLFOX, p = 0.042. A significant shorter median PFS of FOLFOX to Sorafenib of −2.13 (−3.03, −1.24) months, p < 0.001, was reported. Conclusion Despite significantly shorter median OS and PFS than Sorafenib, FOLFOX still extended OS by 8.22 months. This evidence may offer clinical utility to physicians considering treatment options for aHCC in low resource settings.