Sorafenib given with doxorubicin could benefit liver cancer patients
Adding sorafenib to treatment with doxorubicin increases the time to disease progression for patients with hepatocellular carcinoma (HCC) compared with doxorubicin alone, according to a phase II study published in JAMA (2010;304:2154).
Of the 96 patients with advanced HCC recruited to the study, median time to progression was 6.4 months in the doxorubicin plus sorafenib group compared with 2.8 months in the group that received doxorubicin plus placebo (P=0.02).
The study was terminated early on the basis of an unplanned interim analysis of the data, which was prompted by a separate investigation of sorafenib versus placebo for HCC (the SHARP study, New England Journal of Medicine 2008;359:378). This phase III study reported a survival benefit with sorafenib, as did the present interim analysis in JAMA.
Steve Williamson, consultant pharmacist for North of England Cancer Network, told Clinical Pharmacist: “We already know from the SHARP study that sorafenib improves survival for advanced HCC compared with placebo.
“This new phase II study builds on the previous sorafenib data and shows that sorafenib plus doxorubicin may be a very effective combination.”
However, he explained that a phase III trial comparing sorafenib with sorafenib plus doxorubicin is required to evaluate whether the advantage seen is due to sorafenib alone or to the combination with doxorubicin.
“Until then, perhaps the focus should be to secure funding from the cancer drugs fund [England] for sorafenib in HCC patients,” Mr Williamson suggested. Sorafenib was rejected by the National Institute for Health and Clinical Excellence for advanced HCC in May 2010 on the grounds of inadequate cost-effectiveness.
Citation: Clinical Pharmacist URI: 11048898
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