Early alpha-fetoprotein response predicts treatment efficacy of antiangiogenic systemic therapy in patients with advanced hepatocellular carcinoma
Journal
Cancer
Journal Volume
116
Journal Issue
19
Pages
4590-4596
Date Issued
2010
Abstract
BACKGROUND: Antiangiogenic therapy has become the most important treatment modality for patients with advanced hepatocellular carcinoma (HCC). In this study, the authors investigated levels of alpha-fetoprotein (AFP) as a potential biomarker for treatment efficacy of antiangiogenic therapy. METHODS: Patients with advanced HCC who had been enrolled in 3 prospective phase 2 clinical trials that evaluated either sorafenib, bevacizumab, or thalidomide in combination with a potentially antiangiogenic, metronomic, oral 5-fluoropyrimidine as first-line systemic therapy were included. An early AFP response was defined as a decline >20% from baseline after 2 to 4 weeks of treatment. AFP response was analyzed for its association with treatment efficacy and survival outcome. RESULTS: Seventy-two patients were included for early AFP response evaluation, and 12 of those patients (17%) were classified as early AFP responders. Early AFP responders, compared with nonresponders, had a significantly improved overall response rate (33% vs 8%; P=.037) and a significantly improved disease control rate (83% vs 35%; P=.002), which was defined as the percentage of patients who had an objective response plus stable disease for a minimum of 8 weeks. AFP responders, compared with nonresponders, also had longer median progression-free survival (PFS) (7.5 months vs 1.9 months; P=.001) and longer median overall survival (OS) (15.3 months vs 4.1 months; P=.019). In a multivariate analysis, AFP response remained a significant independent predictor of better PFS and OS. CONCLUSIONS: The current results indicated that an early AFP response is a useful surrogate marker to predict treatment response and prognosis in patients with advanced HCC who receive antiangiogenic therapy. ? 2010 American Cancer Society.
SDGs
Other Subjects
alpha fetoprotein; bevacizumab; capecitabine; sorafenib; thalidomide; UFT; alpha fetoprotein; angiogenesis inhibitor; tumor marker; adult; advanced cancer; aged; antiangiogenic therapy; article; clinical trial; drug efficacy; female; human; liver cell carcinoma; major clinical study; male; overall survival; priority journal; progression free survival; treatment outcome; treatment response; blood; Carcinoma, Hepatocellular; Liver Neoplasms; metabolism; middle aged; mortality; prognosis; retrospective study; very elderly; Adult; Aged; Aged, 80 and over; alpha-Fetoproteins; Angiogenesis Inhibitors; Carcinoma, Hepatocellular; Female; Humans; Liver Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Treatment Outcome; Tumor Markers, Biological
Publisher
John Wiley and Sons Inc.
Type
journal article