Advertisement

Clinical Drug Investigation

, Volume 32, Supplement 2, pp 25–35 | Cite as

Current Status of Hepatocellular Carcinoma Treatment in Japan

Practical Use of Sorafenib (Nexavar®)
  • Norihiro KokudoEmail author
  • Junta Nakajima
  • Etsuro Hatano
  • Kazushi Numata
Review Article

Abstract

The efficacy of sorafenib in hepatocellular carcinoma (HCC) has been demonstrated in two pivotal clinical trials: the European SHARP trial and a second trial that recruited patients in the Asia-Pacific region. Sorafenib was approved for the treatment of advanced HCC in Japan based on the results of these studies.

This article presents experiences with sorafenib in patients with HCC at three institutions in Japan, representing the viewpoints of a liver surgeon and a hepatologist at university hospitals, and a hepatologist at a community hospital. The three physicians discuss representative cases and current clinical practice at their institutions, and their recommendations for the use of sorafenib in the wider clinical setting.

Overall, the experiences at these institutions show that sorafenib is most effective when administered for a long time, and the management of adverse events (AEs) [including dose-reduction and modification] is critical to achieving high levels of adherence to treatment. A team-focussed treatment strategy that includes patient counselling and follow-up can contribute to managing AEs to ensure successful continuation of sorafenib therapy. In addition, a proposed definition of unresponsiveness to transarterial chemoembolization and the implications of treatment lag on the outcomes of sorafenib therapy, as well as measures for the prevention and treatment of hand-foot skin reaction are discussed.

Keywords

Sorafenib Tace Skin Reaction Hepatic Arterial Infusion Chemotherapy Sorafenib Treatment 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 10 [Internet]. Lyon, France: International Agency for Research on Cancer; 2010. Available from: http://globocan.iarc.fr [Accessed 2010 Nov]Google Scholar
  2. 2.
    Llovet JM, Ricci S, Mazzaferro V, et al. Sorafenib in advanced hepatocellular carcinoma. N Engl J Med 2008; 359(4): 378–90PubMedCrossRefGoogle Scholar
  3. 3.
    Cheng AL, Kang YK, Chen Z, et al. Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial. Lancet Oncol 2009; 10(1): 25–34PubMedCrossRefGoogle Scholar
  4. 4.
    Bayer. Nexavar approved in Japan for the treatment of advanced liver cancer. [media release]. 2009 May 20 [online]. Available from URL: http://www.onyx-pharm.com/view.cfm/589/Nexavar-Approved-in-Japan-for-the-Treatment-of-Advanced-Liver-Cancer
  5. 5.
    Kudo M, Imanaka K, Chida N, et al. Phase III study of sorafenib after transarterial chemoembolisation in Japanese and Korean patients with unresectable hepatocellular carcinoma. Eur J Cancer 2011; 47(14): 2117–27PubMedCrossRefGoogle Scholar
  6. 6.
    Li X, Feng GS, Zheng CS, et al. Expression of plasma vascular endothelial growth factor in patients with hepatocellular carcinoma and effect of transcatheter arterial chemoembolization therapy on plasma vascular endothelial growth factor level. World J Gastroenterol 2004; 10(19): 2878–82PubMedGoogle Scholar
  7. 7.
    Sergio A, Cristofori C, Cardin R, et al. Transcatheter arterial chemoembolization (TACE) in hepatocellular carcinoma (HCC): the role of angiogenesis and invasiveness. Am J Gastroenterol 2008; 103(4): 914–21PubMedCrossRefGoogle Scholar
  8. 8.
    Kudo M, Kubo S, Takayasu K, et al. Response Evaluation Criteria in Cancer of the Liver (RECICL) proposed by the Liver Cancer Study Group of Japan (2009 Revised Version). Hepatology research: the official journal of the Japan Society of Hepatology 2010; 40(7): 686–92CrossRefGoogle Scholar
  9. 9.
    Kudo M, Izumi N, Kokudo N, et al. Management of Hepatocellular Carcinoma in Japan: Consensus-Based Clinical Practice Guidelines Proposed by the Japan Society of Hepatology (JSH) 2010 Updated Version. Dig Dis 2011; 29(3): 339–64PubMedCrossRefGoogle Scholar
  10. 10.
    Morimoto M, Numata K, Kondo M, et al. Efficacy and safety of sorafenib in advanced hepatocellular carcinoma patients: a multicenter study of Kanagawa Liver Study Group. Kanzo 2010; 51(8): 411–17CrossRefGoogle Scholar
  11. 11.
    Keating GM, Santoro A. Sorafenib: a review of its use in advanced hepatocellular carcinoma. Drugs 2009; 69(2): 223–40PubMedCrossRefGoogle Scholar

Copyright information

© Adis Data Information BV 2012

Authors and Affiliations

  • Norihiro Kokudo
    • 1
    Email author
  • Junta Nakajima
    • 2
  • Etsuro Hatano
    • 3
  • Kazushi Numata
    • 4
  1. 1.Hepato-biliary-pancreatic Surgery Division, Department of Surgery, Graduate School of MedicineUniversity of TokyoBunkyo-ku, TokyoJapan
  2. 2.Third Department of Internal MedicineObihiro-Kosei General HospitalObihiro-City, HokkaidoJapan
  3. 3.Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  4. 4.Gastroenterological CenterYokohama City University Medical CenterMinamiku, Yokohama, KanagawaJapan

Personalised recommendations