Akademik Veri Yönetim Sistemi
CANCERS, cilt.16, sa.3880, ss.1-12, 2024 (SCI-Expanded)
Simple Summary: Liver cancer can sometimes come back after a liver transplant, which creates serious
health challenges for patients. In this study, two medicines, sorafenib and regorafenib, were used to treat
patients with this type of recurring cancer. Patients started with sorafenib, and if this medicine stopped
working or caused too many side effects, they switched to regorafenib. The results showed that using
these medicines one after the other could help patients live longer. However, these treatments can also
lead to strong side effects, so patients need careful monitoring. This study highlights the importance of
personalized care for people facing a return of liver cancer after a transplant.
Abstract: Background and Aims: During liver transplantation, hepatocellular carcinoma (HCC)
recurrence remains a critical challenge for patient survival. Targeted therapies, such as sorafenib
and regorafenib, have been utilized to manage relapsed HCC in this unique setting. This study
aimed to assess the efficacy of Sorafenib and Regorafenib in patients with HCC who experienced
recurrence after liver transplantation. We focused on survival outcomes, treatment responses, and
the management of side effects in this patient group. Methods: We conducted a retrospective
analysis of 73 patients who experienced HCC recurrence post-liver transplantation between 2012
and 2022 across 11 oncology centers in Turkey. Patients were categorized according to Child–Pugh
classification and treated with sorafenib as first-line therapy and Regorafenib in case of progression.
Survival rates were analyzed using the Kaplan–Meier method, and risk factors were evaluated
using Cox regression analysis. Results: Of the 73 patients included in the study, 62 were male
(84.9%), and 11 were female (15.1%), with a mean age of 61.5 ± 10.9 years. All patients received
sorafenib as first-line treatment. Among patients who experienced progression with sorafenib or
discontinued treatment due to toxicity, 45.2% (n = 33) continued treatment with regorafenib. The median progression-free survival (PFS1) time with sorafenib was 5.6 months, and the one-year
survival rate was 24.3%. The median progression-free survival (PFS2) time with regorafenib, which
was administered as second-line treatment, was also calculated as 5.9 months. Overall survival
(OS) duration was determined as 35.9 months. The most common side effects associated with both
drugs included fatigue, hand and foot syndrome, and hypertension. Significantly better survival
outcomes were shown in the Child–Pugh A group compared to other patients. Conclusions: These
results suggest that Sorafenib and Regorafenib treatments offer a survival advantage in patients
with relapsed HCC post-transplantation. However, individualized treatment strategies and close
follow-up are crucial for optimizing outcomes. Further studies are needed to refine therapeutic
protocols and enhance the care of this specific patient group.
Keywords: hepatocellular carcinoma (HCC); liver transplantation; sorafenib; regorafenib; posttransplant
recurrence