The role of tumor burden and liver function in therapy selection for HCC patients

Written by Palmer D, Hawkins N, Vilgrain V et al.

This article provides the results of a post hoc subgroup analysis of the SARAH trial to determine the criteria for stratifying hepatocellular carcinoma (HCC) patients to receive either locoregional therapy or systemic treatment. The research published in Future Oncology concluded that a combination of good liver function and low tumor burden may be relevant in the selection of HCC patients for selective internal radiation therapy (SIRT).

Abstract

Aim: To determine whether a liver tumor burden ≤25% and well-preserved liver function (albumin-bilirubin grade 1) are appropriate criteria for identifying patients with unresectable hepatocellular carcinoma who may benefit from selective internal radiation therapy (SIRT) using 90yttrium resin microspheres versus sorafenib. Patients & methods: Post-hoc analysis of patients in the intention-to-treat population of the SARAH trial (SIRT vs sorafenib) with ≤25% tumor burden and albumin-bilirubin grade 1. Primary end point: overall survival. Results: Median overall survival was 21.9 months (95% CI: 15.2–32.5, n = 37) with SIRT and 17.0 months (11.6–20.8, n = 48) with sorafenib (hazard ratios: 0.73; 95% CI: 0.44–1.21; p = 0.22). Conclusion: A combination of good liver function and low tumor burden may be relevant for selection of hepatocellular carcinoma patients for SIRT.

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