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Open AccessFeature PaperArticle

Sorafenib-Regorafenib Sequential Therapy in Japanese Patients with Unresectable Hepatocellular Carcinoma—Relative Dose Intensity and Post-Regorafenib Therapies in Real World Practice

1
Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 1-26-1,Kyonan-cho, Musashino-shi, Tokyo 180-8610, Japan
2
Department of Gastroenterology and Hepatology, Tokyo Medical Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8510, Japan
3
First Department of internal Medicine, Faculty of Medicine, University of Yamanashi, Shimokato, Chuo, Yamanashi 409-3898, Japan
*
Author to whom correspondence should be addressed.
These two authors contributed equally to this work.
Cancers 2019, 11(10), 1517; https://doi.org/10.3390/cancers11101517
Received: 25 August 2019 / Revised: 3 October 2019 / Accepted: 5 October 2019 / Published: 9 October 2019
(This article belongs to the Special Issue Liver Cancer and Potential Therapeutic Targets)
Background: We aimed to explore the relative dose intensity (RDI) and post-regorafenib treatments in regorafenib therapy. Methods: The medical records of 38 patients treated with regorafenib between July 2017 and June 2019 at our institution were collected. The RDI of regorafenib for the first month (1M-RDI) was calculated. Results: The overall survival (OS) and progression-free survival (PFS) were 12.4 and 3.7 months. The objective response rate and disease control rate were 13.2% and 71.1%. The median total dose of regorafenib in the first month was 2080 mg (240–3360 mg), and the median 1M-RDI was 61.9% (7.1%–100%). Patients with 1M-RDI ≥ 50% showed significantly longer OS and PFS than patients with 1M-RDI < 50% (HR 0.19, 95% CI 0.08–0.48, p = 0.0004 and HR 0.2, 95% CI 0.08–0.52, p = 0.0008). A 1M-RDI ≥ 50% (HR 0.18, 95% CI 0.06–0.55, p = 0.002) and hand–foot skin reaction (HR 0.03, 95% CI 0.008–0.16, p < 0.0001) were independently associated with OS. Post-regorafenib therapies were performed in 19 (86.4%) of 22 patients who had stopped regorafenib due to disease progression. Conclusion: A 1M-RDI ≥ 50% is clinically significant. Post-regorafenib therapies are commonly performed in real-world practice.
Keywords: Hepatocellular carcinoma; sorafenib; regorafenib; sequential therapy; relative dose intensity (RDI) Hepatocellular carcinoma; sorafenib; regorafenib; sequential therapy; relative dose intensity (RDI)
MDPI and ACS Style

Wang, W.; Tsuchiya, K.; Kurosaki, M.; Yasui, Y.; Inada, K.; Kirino, S.; Yamashita, K.; Sekiguchi, S.; Hayakawa, Y.; Osawa, L.; Okada, M.; Higuchi, M.; Takaura, K.; Maeyashiki, C.; Kaneko, S.; Tamaki, N.; Nakanishi, H.; Itakura, J.; Takahashi, Y.; Asahina, Y.; Enomoto, N.; Izumi, N. Sorafenib-Regorafenib Sequential Therapy in Japanese Patients with Unresectable Hepatocellular Carcinoma—Relative Dose Intensity and Post-Regorafenib Therapies in Real World Practice. Cancers 2019, 11, 1517.

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