YU-YUN SHAOCHIH-HORNG WULI-CHUN LUChan S.-Y.Ma Y.-Y.Yen F.-C.CHIH-HUNG HSUANN-LII CHENG2020-04-102020-04-1020140168-8278https://www.scopus.com/inward/record.uri?eid=2-s2.0-84892538394&doi=10.1016%2fj.jhep.2013.08.027&partnerID=40&md5=5d2a2c362c76d8d4ba663e1f8bca9368https://scholars.lib.ntu.edu.tw/handle/123456789/484086Background & Aims No approved therapy is available for patients with advanced hepatocellular carcinoma (HCC) who fail first-line therapy. The prognosis of these patients, especially those eligible for clinical trials of second-line therapy, is unclear. Methods All patients who participated in clinical trials of first-line systemic therapy for metastatic or locally advanced HCC in a referral center of Taiwan between 2005 and 2011 were included. Their clinicopathologic characteristics, when the first-line treatment failed, were analyzed and correlated with the overall survival (OS) from the date of first-line treatment failure. Results A total of 192 patients were included. Before the start of the first-line therapy, all patients had Child-Pugh class A liver reserves and Cancer of the Liver Italian Program (CLIP) scores ?4. After the failure of the first-line therapy, the median OS of the entire group was 4.0 months. Patients with Child-Pugh class A liver reserves, when the first-line treatment failed, had significantly better OS than patients with Child-Pugh class B or C liver reserves (median, A vs. B vs. C = 7.5 vs. 1.3 vs. 1.0 month, p <0.001). According to the key eligibility criteria of 3 published clinical trials for second-line therapy, 41%-56% of patients were potentially eligible. Compared to patients who were ineligible for clinical trials, potentially eligible patients had longer OS with a median of 7.8-8.6 months. Conclusions Patients with advanced HCC who failed first-line therapy could have substantially improved prognosis if they had Child-Pugh A liver reserves or were potentially eligible for clinical trials.[SDGs]SDG3alpha fetoprotein; bevacizumab; brivanib; capecitabine; erlotinib; fluorouracil derivative; placebo; sorafenib; sunitinib; tamoxifen; thalidomide; tivantinib; UFT; adult; advanced cancer; article; cancer prognosis; cancer survival; Child Pugh score; correlation analysis; human; hyperbilirubinemia; liver cell carcinoma; middle aged; overall survival; phase 2 clinical trial (topic); phase 3 clinical trial (topic); priority journal; systemic therapy; Taiwan; treatment failure; Barcelona Clinic Liver Cancer; BCLC; Cancer of the Liver Italian Program; Clinical trials; CLIP; Eastern Cooperative Oncology Group performance status; ECOG PS; HCC; Hepatocellular carcinoma; hepatocellular carcinoma; National Taiwan University Hospital; NTUH; OS; overall survival; Prognosis; Second-line therapy; Survival; time to progression; TTP; Adult; Aged; Aged, 80 and over; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Hepatocellular; Female; Humans; Kaplan-Meier Estimate; Liver Neoplasms; Male; Middle Aged; Prognosis; Taiwan; Treatment Failure; Treatment Outcome; Young Adultjournal article10.1016/j.jhep.2013.08.027240360082-s2.0-84892538394