Gerda Elisabeth Villadsen

Regorafenib Efficacy After Sorafenib in Patients With Recurrent Hepatocellular Carcinoma After Liver Transplantation: A Retrospective Study

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DOI

  • Massimo Iavarone, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
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  • Federica Invernizzi, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
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  • Tommy Ivanics, University Health Network
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  • Stefano Mazza, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
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  • Claudio Zavaglia, Niguarda Hospital
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  • Marco Sanduzzi-Zamparelli, University of Barcelona
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  • Miguel Fraile-López, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias
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  • Carolin Czauderna, Johannes Gutenberg University Mainz
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  • Giovanni Di Costanzo, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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  • Sherrie Bhoori, IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori - Milano
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  • Matthias Pinter, Medical University of Vienna
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  • Matteo Angelo Manini, Papa Giovanni XXIII Hospital
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  • Giuliana Amaddeo, Hopital Henri Mondor
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  • Ainhoa Fernandez Yunquera, Complutense University of Madrid
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  • Federico Piñero, Universidad Austral
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  • Maria Jose Blanco Rodríguez, Hospital de Jerez
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  • Margarita Anders, Hospital Alemán
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  • Gabriel Aballay Soteras, Sanatorio de la Trinidad
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  • Gerda Elisabeth Villadsen
  • Peter Daechul Yoon, University Health Network
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  • Lucia Cesarini, Niguarda Hospital
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  • Álvaro Díaz-González, University of Barcelona
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  • Maria Luisa González-Diéguez, University of Oviedo
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  • Raffaella Tortora, Azienda Ospedaliera di Rilievo Nazionale Antonio Cardarelli
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  • Arndt Weinmann, Johannes Gutenberg University Mainz
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  • Vincenzo Mazzaferro, IRCCS Fondazione Istituto Nazionale per lo studio e la cura dei tumori - Milano
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  • Mario Romero Cristóbal, Complutense University of Madrid
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  • Gonzalo Crespo, University of Barcelona
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  • Helene Regnault, Hopital Henri Mondor
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  • Massimo De Giorgio, Papa Giovanni XXIII Hospital
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  • Maria Varela, University of Oviedo, Instituto de Investigación Sanitaria del Principado de Asturias
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  • Rebecca Prince, University of Toronto
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  • Luigia Scudeller, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
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  • Maria Francesca Donato, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano
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  • Marcus Alexander Wörns, Johannes Gutenberg University Mainz
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  • Jordi Bruix, University of Barcelona
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  • Gonzalo Sapisochin, University Health Network
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  • Pietro Lampertico, IRCCS Fondazione Ca'Granda – Ospedale Maggiore Policlinico - Milano, University of Milan
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  • Maria Reig, University of Barcelona

Safety of regorafenib in hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) has been recently demonstrated. We aimed to assess the survival benefit of regorafenib compared with best supportive care (BSC) in LT patients after sorafenib discontinuation. This observational multicenter retrospective study included LT patients with HCC recurrence who discontinued first-line sorafenib. Group 1 comprised regorafenib-treated patients, whereas the control group was selected among patients treated with BSC due to unavailability of second-line options at the time of sorafenib discontinuation and who were sorafenib-tolerant progressors (group 2). Primary endpoint was overall survival (OS) of group 1 compared with group 2. Secondary endpoints were safety and OS of sequential treatment with sorafenib + regorafenib/BSC. Among 132 LT patients who discontinued sorafenib included in the study, 81 were sorafenib tolerant: 36 received regorafenib (group 1) and 45 (group 2) received BSC. Overall, 24 (67%) patients died in group 1 and 40 (89%) in group 2: the median OS was significantly longer in group 1 than in group 2 (13.1 versus 5.5 months; P < 0.01). Regorafenib treatment was an independent predictor of reduced mortality (hazard ratio, 0.37; 95% confidence interval [CI], 0.16-0.89; P = 0.02). Median treatment duration with regorafenib was 7.0 (95% CI, 5.5-8.5) months; regorafenib dose was reduced in 22 (61%) patients for adverse events and discontinued for tumor progression in 93% (n = 28). The median OS calculated from sorafenib start was 28.8 months (95% CI, 17.6-40.1) in group 1 versus 15.3 months (95% CI, 8.8-21.7) in group 2 (P < 0.01). Regorafenib is an effective second-line treatment after sorafenib in patients with HCC recurrence after LT.

Original languageEnglish
JournalLiver Transplantation
Volume27
Issue12
Pages (from-to)1767-1778
Number of pages12
ISSN1527-6465
DOIs
Publication statusPublished - Dec 2021

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