Conference Coverage
The data for this study were limited due to a small sample size, and it was not powered to evaluate for statistically significant characteristics between the patients who survived at the 1-year follow-up and the patients who did not survive at the 1-year follow-up. This information would be useful to identify potential prognostic factors and guide providers in sorafenib management. Finally, a long-term safety profile could not be established, as patients were evaluated for a 1-year period.
Ultimately, HCC is a multifactorial disease, and it is difficult to account for all potential confounding factors. Additional research, including studies comparing sunitinib or a control group to sorafenib, may provide further insight.
Conclusions
In light of these results, the authors believe that sorafenib may be considered for veterans with unresectable HCC and who are contraindicated for alternative treatments. One-year survival rates were similar to those seen in previous studies. However, there was no clear association between the duration of treatment and OS, and although the medication was well tolerated, there were also serious AEs. It is prudent to continually assess the need for therapy throughout the treatment period.
Pharmacists have a critical role in care for oncology patients, from the integration of certified clinical pharmacist practitioners into hematology-oncology clinics to patient monitoring through oral oncology pharmacy programs.19,20 These programs have been shown to improve patient outcomes and decrease overall health care use and may benefit the veteran population.
In this study, a veteran population achieved a survival rate at the 1-year follow-up similar to that found in SHARP: 40.5% vs 44%. However, OS was markedly shorter: 5.9 months vs 10.7 months. Patients with minimal impact from HCC, such as mild hepatic impairment and high functional status, demonstrated higher survival rates at the 1-year follow-up than did those with significant compromise. Thirty-five patients experienced ≥1 AE, most observed within the first 90 days of treatment, and for 3 patients, sorafenib could not be ruled out as the cause of death.
Sorafenib remains a viable therapeutic option for veterans with advanced HCC. However, it is uncertain how much benefit sorafenib affords to the veteran population, especially with the associated risks.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.