Skin toxicities and survival in advanced hepatocellular carcinoma patients treated with sorafenib

Taiga Otsuka, Yuichiro Eguchi, Seiji Kawazoe, Kimihiko Yanagita, Keisuke Ario, Kenji Kitahara, Hiroaki Kawasoe, Hiroyuki Kato, Toshihiko Mizuta

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)


Aim: Sorafenib is the first small molecule with significant clinical activity for advanced hepatocellular carcinoma (HCC). However, intolerable adverse events are sometimes observed. On the other hand, it has been reported that some toxicities of molecular targeted drugs, such as skin toxicities and arterial hypertension, are correlated with good clinical outcomes in other cancers. Methods: We identified the correlations between adverse events and prognosis for sorafenib therapy in all patients with HCC treated at the institutions of the Saga Liver Cancer Study Group. The toxicities were assessed using the Common Terminology Criteria for Adverse Events version 4.0. Results: Ninety-four patients received sorafenib until August 2010. The overall incidence of treatment-related adverse events was 98% of patients. Skin toxicities, including palmar-plantar erythrodysesthesia syndrome, rash, pruritus and alopecia, were the most common adverse events and were observed in 58 patients (62%). Hypertension was observed in 23 patients (24%). The median survival time was 12.5months among the total patients. The patients with skin toxicities showed significantly longer survival than the patients without these toxicities (hazard ratio, 0.449; 95% confidence interval, 0.256-0.786; P=0.005). Hypertension had no correlation with survival. Skin toxicities were also significant prognostic factors in a multivariate analysis (hazard ratio, 0.522; 95% confidence interval, 0.274-0.997; P=0.049), along with Child-Pugh class and α-fetoprotein level. The median development time for skin toxicities was 21days. Conclusion: Skin toxicities occur commonly at the early phase in patients treated with sorafenib, and could be a promising surrogate marker for the treatment outcome.

Original languageEnglish
Pages (from-to)879-886
Number of pages8
JournalHepatology Research
Issue number9
Publication statusPublished - 09-2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases


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