Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
Ergebnis 15 von 6848

Details

Autor(en) / Beteiligte
Titel
The albumin–bilirubin grade improves hepatic reserve estimation post‐sorafenib failure: implications for drug development
Ist Teil von
  • Alimentary pharmacology & therapeutics, 2017-03, Vol.45 (5), p.714-722
Ort / Verlag
England: Wiley Subscription Services, Inc
Erscheinungsjahr
2017
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
  • Summary Background Drug development in hepatocellular carcinoma (HCC) is limited by disease heterogeneity, with hepatic reserve being a major source of variation in survival outcomes. The albumin–bilirubin (ALBI) grade is a validated index of liver function in patients with HCC. Aim To test the accuracy of the ALBI grade in predicting post‐sorafenib overall survival (PSOS) in patients who permanently discontinued treatment. Methods From a prospectively maintained international database of 447 consecutive referrals, we derived 386 eligible patients treated with sorafenib within Barcelona Clinic Liver Cancer C stage (62%), 75% of whom were of Child class A at initiation. Clinical variables at sorafenib discontinuation were analysed for their impact on post‐sorafenib overall survival using uni‐ and multivariable analyses. Results Median post‐sorafenib overall survival of the 386 eligible patients was 3.4 months and median sorafenib duration was 2.9 months, with commonest causes of cessation being disease progression (68%) and toxicity (24%). At discontinuation, 92 patients (24%) progressed to terminal stage, due to worsening Child class to C in 40 (10%). Median post‐sorafenib overall survival in patients eligible for second‐line therapies (n = 294) was 17.5, 7.5 and 1.9 months according respectively to ALBI grade 1, 2 and 3 (P < 0.001). Conclusions The ALBI grade at sorafenib discontinuation identifies a subset of patients with prolonged stability of hepatic reserve and superior survival. This may allow improved patient selection for second‐line therapies in advanced HCC.

Weiterführende Literatur

Empfehlungen zum selben Thema automatisch vorgeschlagen von bX