AsianScientist (Sep. 13, 2019) – In a study published in the journal Cancers, scientists in Taiwan and Japan have demonstrated that a radiological procedure called transarterial chemoembolization (TACE), combined with a drug called sorafenib, produces better outcomes in liver cancer patients.
Liver cancer affects hundreds of thousands of people annually, and there are few viable therapies for the advanced stages of its most common form—hepatocellular carcinoma. Sorafenib, a small molecule inhibitor drug, improves overall survival in patients with advanced hepatocellular carcinoma and is considered a standard treatment. However, questions remain over how to increase the effectiveness of sorafenib in the clinic.
During the past decade, scientists began to test whether TACE can raise patient survival even further. This therapy involves blocking blood vessels leading into a tumor, depriving the tumor of blood and thereby killing the malignant cells. Few studies have focused on the combined effectiveness of TACE and sorafenib.
In the present study, researchers from Taiwan and Japan, led by Dr. Victor Kok from Kuang Tien General Hospital Cancer Center and Asia University Taiwan, performed the first large, national-level, population-based cohort study examining the influence of TACE on the effectiveness of sorafenib against liver cancer.
The team analyzed data on liver-cancer patients from the Taiwan National Health Insurance Research Database, which is highly representative of Taiwan’s population. They used a statistical method called propensity matching to eliminate confounding factors such as patient age, sex and socioeconomic status.
After tracking the data of 2,112 Taiwanese patients until their death or the end of the study, Kok’s group identified a 26 percent decrease in mortality when TACE was added to sorafenib treatment, compared with sorafenib treatment alone. More specifically, six months and one year after treatment, median overall survival was 80.3 percent and 53.5 percent respectively in the patients receiving combined therapy. In contrast, median overall survival of patients six months and one year after sorafenib-only treatment was 54.4 percent and 32.4 percent respectively.
The improvement in survival was present regardless of whether patients received only one session of TACE or more. Also encouraging was the fact that patients appeared to tolerate the combination treatment well—negative side-effects were similar between patients treated with sorafenib alone or those receiving combined therapy.
“Right now, oncologists aren’t necessarily offering TACE as a treatment option because the evidence for its effectiveness isn’t fully developed. But here, we’ve used a very large dataset to show that TACE can be added to a sorafenib-based treatment and improve its outcome,” said Kok.
“We’re hoping that this will signal an advancement in liver cancer therapy, while also encouraging more research on the molecular mechanisms of exactly how sorafenib synergizes with TACE to control liver tumors. A better understanding of the underlying processes responsible for this additive, positive effect could help us identify further treatments,” he added.
The article can be found at: Kok et al. (2019) Sorafenib with Transarterial Chemoembolization Achieves Improved Survival vs. Sorafenib Alone in Advanced Hepatocellular Carcinoma: A Nationwide Population-Based Cohort Study.
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Source: Cactus Communications; Photo: Shutterstock.
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