THE USE OF SECOX (SORAFENIB, OXALIPLATIN, CAPCITABINE) AS THE TREATMENT OF ADVANCED HEPATOCELLULAR CARCINOMA (HCC): A SINGLE-CENTER ANALYSIS

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Abstract

Background

Combining sorafenib with chemotherapy can potentially provide a new regime with enhanced benefit. Phase II study has demonstrated promising activity in combining sorafenib, oxaliplatin and capecitabine (SECOX) in treating advanced HCC. We reported our experience in using this regime in our centre.

Methods

This retrospective study included all consecutive advanced HCC patients treated in our centre with SECOX regimen: daily oral sorafenib 400 mg B.D., oxaliplatin 85 mg/m2 infusion on D1, and oral capcitabine 850 mg/m2 B.D. from day 1 to 7 every 2 weeks. Univariate and multivariateble analyses were employed to explore the potential predictive factors for overall survival benefits treated with this combination.

Results

Eighty-nine patients were included in the analysis with 29 patients previously enrolled in the phase II trial and 60 patients treated outside the clinical trial in our centre. Of 89 patients received SECOX (male, 85%; median age, 53 years; hepatitis B carrier, 91%), 72 (81%) patients had CP A and 17 (29%) patients had CP B. Moreover, 42.7% patients had ECOG performance status (PS) 0, 53.9% patients had PS 1 and 3.4% patients had PS 2. The most common grade 3 or 4 drug-related toxic effects were hand-foot syndrome (10.5%), diarrhea (5.8%), and hypertension (5.8%). G3/4 thrombocytopenia was found in 18.1% and neutropenia was present in 6.0%. The overall response rate was 14.6%, with one (1.1%) patient had complete response and 12 (13.5%) patients achieved partial response. Moreover, 30 (33.7%) patients had stable disease. Overall, 48.3% patients derived benefits from SECOX. The progression-free survival (PFS) was 4.1 months (95% CI 3.6–4.6) and median overall survival (OS) was 11.0 months (95% CI 8.2–12.3). Patients with CP A cirrhosis had better PFS (4.2 versus 2.9 months, P = 0.027) and OS (11.8 versus 5 months, P = 0.003) than CP B patients. Multivariateble analysies revealed that both ECOG 1-2 (P = 0.0056) and baseline AFP level ≥400 ng/ml vascular involvement (P = 0.04812) were associated with worse overall survival.

Conclusions

The SECOX regime had promising activity in advanced HCC with good tolerability, especially in Child-Pugh A patients with a good performance status.

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