Preprint Article Version 1 This version is not peer-reviewed

Use of Sorafenib and Regorafenib in Hepatocellular Cancer Recurrence After Liver Transplantation: Treatment Strategies and Outcomes

Mehmet Fatih Ozbay
* ORCID logo ,
Hakan Harputluoglu
,
Mustafa Karaca
* ,
Omer Tekin
,
Mehmet Ali Nahit Şendur
,
Muhammed Ali Kaplan
,
Berksoy Sahin
,
Caglayan Geredeli
,
Fatih teker Teker
ORCID logo ,
Deniz Tural
,
Sezer Saglam
,
Timuçin Çil
,
Ahmet Bilici
,
Cihan Erol
ORCID logo ,
Ziya Kalkan
ORCID logo ,
Ertugrul Bayram
ORCID logo ,
Oguzhan Selvi
,
İlkay Gültürk
ORCID logo ,
Sema Sezgin Göksu
,
Ali Murat Tatlı
Version 1 : Received: 28 October 2024 / Approved: 29 October 2024 / Online: 29 October 2024 (11:03:35 CET)

How to cite: Ozbay, M. F.; Harputluoglu, H.; Karaca, M.; Tekin, O.; Şendur, M. A. N.; Kaplan, M. A.; Sahin, B.; Geredeli, C.; Teker, F. T.; Tural, D.; Saglam, S.; Çil, T.; Bilici, A.; Erol, C.; Kalkan, Z.; Bayram, E.; Selvi, O.; Gültürk, İ.; Göksu, S. S.; Tatlı, A. M. Use of Sorafenib and Regorafenib in Hepatocellular Cancer Recurrence After Liver Transplantation: Treatment Strategies and Outcomes. Preprints 2024, 2024102285. https://doi.org/10.20944/preprints202410.2285.v1 Ozbay, M. F.; Harputluoglu, H.; Karaca, M.; Tekin, O.; Şendur, M. A. N.; Kaplan, M. A.; Sahin, B.; Geredeli, C.; Teker, F. T.; Tural, D.; Saglam, S.; Çil, T.; Bilici, A.; Erol, C.; Kalkan, Z.; Bayram, E.; Selvi, O.; Gültürk, İ.; Göksu, S. S.; Tatlı, A. M. Use of Sorafenib and Regorafenib in Hepatocellular Cancer Recurrence After Liver Transplantation: Treatment Strategies and Outcomes. Preprints 2024, 2024102285. https://doi.org/10.20944/preprints202410.2285.v1

Abstract

Abstract Background andAims: 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 11oncology centers in Turkey. Patients were categorised according to Child-Pugh classification and treated with Sorafenib as first-line therapy and Regorafenib in case of progression. Survival rates were analysed by Kaplan-Meier method and risk factors were evaluated by 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-foot syndrome and hypertension. Significantly better survival outcomes were shown in the Child-Pugh A group compared to other patients. Conclusion: 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; Post-transplant recurrence

Subject

Medicine and Pharmacology, Oncology and Oncogenics

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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