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Background <p>Hepatitis C virus (HCV) has been linked to lower tumor growth rates, higher sorafenib efficacy, and greater survival of patients treated for hepatocellular carcinoma (HCC). In real-world settings, we tried to elucidate the effectiveness of sorafenib therapy for patients with HCV-related HCC with previous direct-acting antiviral (DAAs) therapy or not.</p> Methods <p>This retrospective multicenter work recruited participants with sorafenib-treated HCC with and without previous DAAs therapy from November 2016 to April 2023 and followed up until death or the study end in April 2024. We compared the patients’ clinico-laboratory, imaging variables, and overall survival (OS).</p> Results <p>This work included 622 patients; 535 patients received DAAs before the development of HCC (group I), and 87 patients did not (group II). Group II patients showed higher rates of nausea, vomiting, and diarrhea than group I patients, while group I patients experienced higher rates of jaundice during sorafenib therapy. None of the patients achieved complete response (CR) after sorafenib. Patients previously treated with DAAs were less common to show partial response (PR) (12.9% versus 23%, respectively, <i>P</i>-value 0.011). The disease control rate (PR + CR + stable disease (SD)) was 45% in group I and 52.9% in group II. Group I had a considerably reduced median survival rate. The patients with SVR prior to HCC development had a median OS that was significantly lower than both non-responder patients (285.00 versus 629.00&#xa0;days, respectively, <i>P</i>-value &lt; 0.001) and patients without DAAs (285.00 versus 580.00&#xa0;days, respectively, <i>P</i>-value &lt; 0.001).</p> Conclusion <p>DAAs therapy before the onset of HCC might be linked to lower rates of response to sorafenib compared to DAAs-naïve patients. Furthermore, it might be connected to a decreased overall survival rate in patients treated with sorafenib.</p>

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Sorafenib-treated hepatocellular carcinoma with or without prior direct-acting antiviral therapy for hepatitis C: outcomes and survival

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年8月16日

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  • Rania Lithy,
  • Mohamed Kohla,
  • Hossam Dabees,
  • Hend Ibrahim Shousha,
  • Ehab Fawzy,
  • Eman M. F. Barakat,
  • Mohamed El-Kassas,
  • Mona Shoukry Aziz,
  • Eman Elkhateeb,
  • Ashraf Omar Abdelaziz,
  • Mohamed Omar Abdelmalek,
  • Ali Azmy,
  • Ahmed Tawheed,
  • Reem Abdelghafour,
  • Hossam Taha,
  • Mohamed Mahmoud Nabeel,
  • Mohamed A. Medhat,
  • Dalia Ghoraba,
  • Hamdy Sayed,
  • Anwar Nassief,
  • Mostafa Elhelbawy,
  • Tamer Elbaz,
  • Ahmed Radwan,
  • Safaa Ragab Askar,
  • Eman Marwan,
  • Eman Rewisha,
  • Ahmed Hosni Abdelmaksoud,
  • Sayed Hassan Ahmed,
  • Nevien Fouad Elfouly,
  • Nermeen Abdeen,
  • Ahmed Ramadan,
  • Asmaa A. Abdeltawab,
  • Mostafa Abd Alfattah Shamkh,
  • Yasser Arafat Abdelrazek,
  • Ammar Alrajhi,
  • Sayed Ahmed Sayed,
  • Ahmed A. Sleem,
  • Rasha Salah Hussein,
  • Allam Elsayed Allam,
  • Omnia A. Seyam,
  • Mohamed Said

摘要

Background

Hepatitis C virus (HCV) has been linked to lower tumor growth rates, higher sorafenib efficacy, and greater survival of patients treated for hepatocellular carcinoma (HCC). In real-world settings, we tried to elucidate the effectiveness of sorafenib therapy for patients with HCV-related HCC with previous direct-acting antiviral (DAAs) therapy or not.

Methods

This retrospective multicenter work recruited participants with sorafenib-treated HCC with and without previous DAAs therapy from November 2016 to April 2023 and followed up until death or the study end in April 2024. We compared the patients’ clinico-laboratory, imaging variables, and overall survival (OS).

Results

This work included 622 patients; 535 patients received DAAs before the development of HCC (group I), and 87 patients did not (group II). Group II patients showed higher rates of nausea, vomiting, and diarrhea than group I patients, while group I patients experienced higher rates of jaundice during sorafenib therapy. None of the patients achieved complete response (CR) after sorafenib. Patients previously treated with DAAs were less common to show partial response (PR) (12.9% versus 23%, respectively, P-value 0.011). The disease control rate (PR + CR + stable disease (SD)) was 45% in group I and 52.9% in group II. Group I had a considerably reduced median survival rate. The patients with SVR prior to HCC development had a median OS that was significantly lower than both non-responder patients (285.00 versus 629.00 days, respectively, P-value < 0.001) and patients without DAAs (285.00 versus 580.00 days, respectively, P-value < 0.001).

Conclusion

DAAs therapy before the onset of HCC might be linked to lower rates of response to sorafenib compared to DAAs-naïve patients. Furthermore, it might be connected to a decreased overall survival rate in patients treated with sorafenib.