Vol. 4, Issue 1, Part B (2024)

Background: Sorafenib represents the primary therapeutic option for people diagnosed with advanced hepatocellular carcinoma (HCC). Nevertheless, it is linked to a range of drug-related negative effects, impacting all cases having low objective response rates along with limited survival prolongation. This work was aimed at assessing the correlation between the early clinical response following a two-week period of Sorafenib therapy and the outcomes in patients with advanced HCC.
Methods: The prospective, observational and non-interventional study included 20 cases, with ages above 18 years, both sexes, developing typical HCC, hyper vascular HCC in the liver at baseline, Child-Pugh class A disease as regards liver function along with eastern cooperative oncology group performance status of 0 or 1. Triphasic-computed tomography (CT) images were obtained for all patients at baseline, within two and six weeks following Sorafenib administration, and then every 8 weeks till 6 months. 
Results: Our prompt evaluation of Sorafenib treatment demonstrated a favorable overall survival rate (p<0.001) as well as progression free survival among cases whose arterial tumor enhancement disappeared on triphasic-CT, whose alpha fetoprotein (AFP) level decreased within the first two weeks following the dose and patients who had preserved liver function within a two-weeks following Sorafenib. These factors were all most significant and independent predictors of favorable overall survival rate (p<0.001) as well as progression free survival (p<0.001). They exhibited a significant correlation with a significantly reducred rate of disease progression at 6 weeks (p= 0.029). 
Conclusions: For patients with advanced HCC, alterations as regards intra-tumor blood flow using triphasic-CT, AFP levels, as well as remnant liver function following a two-weeks period using sorafenib may be helpful in the outcome prediction as well as the anti-tumor effect of sorafenib therapy and can help identify patients should discontinue receiving it with early switch to second line therapy to avoid unnecessary toxicities and costs when sorafenib therapy is ineffective.