Value of α‑fetoprotein as an early biomarker for treatment response to sorafenib therapy in advanced hepatocellular carcinoma

Plano Sánchez,Ana  Isabel; Velasco Roces,Lucía; Zapico García,Isabel; Lázaro López,Eva; Calleja Hernandez,Miguel   Angel; Baena Parejo,Maria   Isabel; Peña‑Díaz,Jaime

doi:10.3892/ol.2018.8400

Value of α‑fetoprotein as an early biomarker for treatment response to sorafenib therapy in advanced hepatocellular carcinoma

Authors:
- Ana Isabel Plano Sánchez
- Lucía Velasco Roces
- Isabel Zapico García
- Eva Lázaro López
- Miguel Angel Calleja Hernandez
- Maria Isabel Baena Parejo
- Jaime Peña‑Díaz
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Affiliations: Hospital Pharmacy Department, Central University Hospital of Asturias, Oviedo, 33011 Asturias, Spain, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain
Published online on: March 30, 2018 https://doi.org/10.3892/ol.2018.8400
Pages: 8863-8870

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Abstract

Sorafenib is an oral multikinase inhibitor with antiangiogenic and antiproliferative properties, and is used as the first‑line treatment for patients with advanced hepatocellular carcinoma (HCC). Previous studies have identified an improvement in overall survival and progression‑free survival in patients with a manageable toxicity profile. α‑fetoprotein (AFP) has been revealed to be of great diagnostic and predictive value for tumour staging in multiple studies; however, its role as a predictive factor of response to treatment with sorafenib is not entirely clear. The present study aimed to determine the effectiveness of sorafenib and investigate the value of AFP as a predictive factor of early response to sorafenib in patients with HCC. Effectiveness was analysed based on median overall survival (mOS) time, while to analyse the possible predictive value of AFP, patients were classified into two groups: Non‑responders (≤20% AFP reduction) and responders (>20% AFP reduction) at 6‑8 weeks of treatment when compared with basal AFP level. For assessment of toxicity, any adverse effects were recorded. A total of 167 patients were included, who collectively exhibited a mOS time of 11 months with a median treatment duration of 5 months. The mOS time was significantly higher for patients with better hepatic function (12 months in cases of Child‑Pugh score A vs. 8 months in cases of Child‑Pugh score B; P=0.03) and with basal AFP values ≤200 ng/ml (14 months vs. 8 months in patients with AFP levels >200 ng/ml; P=0.01). A >20% reduction of AFP at 6‑8 weeks was determined to be a positive predictive factor upon multivariate analysis (P=0.002), obtaining, for the responder patients, an mOS of 18 months compared with 10 months (P=0.004) for the non‑responders. The main adverse reactions were hand‑foot syndrome (35/167; 21%), diarrhoea (39/167; 23.4%), anorexia (29/167; 17.4%) and arterial hypertension (30/167; 18%). In conclusion, a >20% drop in AFP at 6‑8 weeks may be useful as a predictive factor of response to sorafenib, as indicated by its association with longer survival times in patients with advanced HCC following treatment with sorafenib in the present study.

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