Sorafenib Plus Hepatic Arterial Infusion Chemotherapy with Oxaliplatin Versus Sorafenib Alone for Advanced Hepatocellular Carcinoma

Objective: To compare the efficacy of sorafenib plus hepatic arterial infusion chemotherapy (HAIC) with oxaliplatin to that of sorafenib alone in patients with advanced hepatocellular carcinoma (HCC).

Methods: This was a retrospective, single-center trial. Between April 3, 2017 and July 2, 2018, 104 patients with Child-Pugh A and advanced HCC received either 400 mg of sorafenib orally twice daily plus HAIC with oxaliplatin (oxaliplatin 85 mg/m, every 3 weeks via repetitive catheterization) (n = 46, soraOXA group) or 400 mg of only sorafenib orally twice daily (n = 58, sorafenib group). Overall survival, progression-free survival, objective response rate, and treatment-related adverse events were compared.

Results: The median overall survival was 9.37 months (95% CI, 7.05-11.68) in the soraOXA group versus 4.8 months (95% CI, 2.98-6.62) in the sorafenib group (HR 0.46 [95% CI, 0.29-0.72];  < 0.001). The soraOXA group also showed a higher objective response rate (16 [34.8%] vs 1 [1.7%];  < 0.001) and a longer progression-free survival rate (5.5 months [95% CI, 2.32-8.68] vs 2.4 months [95% CI, 1.65-3.15], HR 0.54 [95% CI, 0.36-0.81],  = 0.003) than the sorafenib group. There was no significant difference in the overall incidence of any grade adverse events, grade 3/4 adverse events, serious adverse events, or incidence of treatment termination due to adverse events between the two groups.

Conclusion: Compared with sorafenib alone, sorafenib plus HAIC with oxaliplatin showed favorable treatment outcomes in patients with advanced HCC. The merits of this approach need to be established with a prospective trial.