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Latest outcomes from the Part III NRG-RTOG 1112 scientific examine confirmed that the addition of stereotactic physique radiotherapy (SBRT) to systemic remedy with sorafenib considerably improved progression-free survival (PFS) and time-to-progression in sufferers with regionally superior hepatocellular carcinoma (HCC) when in comparison with sorafenib alone. Moreover, the addition of SBRT to sorafenib was related to clinically necessary enhancements in general survival (OS) for sufferers with regionally superior HCC.
These outcomes have been just lately printed in JAMA Oncology.
“Typically, patients treated with systemic therapy for locally advanced hepatocellular carcinoma recur within the liver following treatment. Invasion of HCC into the large hepatic vessels, referred to as macrovascular invasion (MVI), is associated with increased risk of metastases and lower survival. This population has an unmet need to better control cancer and improve survival outcomes,” said Laura A. Dawson MD, Professor and Chair of the Division of Radiation Oncology, Temerty Medication, College of Toronto, radiation oncologist on the Princess Margaret Most cancers Centre, College Well being Community, and the lead writer of the NRG-RTOG 1112 manuscript.
“The improved outcomes observed with the addition of SBRT, particularly in patients with MVI, are consistent with prior smaller studies and provide evidence for the efficacy of SBRT in patients with HCC. These results also provide strong rationale for randomized studies of SBRT combined with immunotherapy for patients with HCC and MVI, which are planned.”
NRG-RTOG 1112 accrued 177 eligible sufferers and stratified sufferers by efficiency standing, liver operate, diploma of metastases, and diploma of MVI. MVI was seen in 131 out of 177 (74%) of sufferers accrued. Sufferers have been randomly assigned to obtain both SBRT with sorafenib or sorafenib alone. Sufferers receiving SBRT acquired 27.5 to 50 Gy in 5 fractions. The first endpoint of this examine was OS; secondary endpoints included PFS, antagonistic occasions, and high quality of life.
The median OS was 12.3 months on the sorafenib alone therapy arm (90% CI 10.6–14.3) versus 15.8 months on the sorafenib with SBRT therapy arm (90% CI 11.4–19.2) (hazard ratio [HR] 0.77, 90% CI 0.59–1.01, 1-sided p=0.055).
Moreover, median PFS was improved from 5.5 months on the sorafenib alone therapy arm (95% CI 3.4–6.3) to 9.2 months on the SBRT with sorafenib therapy arm (7.5–11.9) (HR, 0.55, 95% CI 0.40–0.75, 2-sided p
High quality of life at 6 months was additionally improved with the addition of SRBT. High quality of life enchancment was seen in 10% of sufferers who have been on the sorafenib alone therapy arm versus 35% of sufferers on the SBRT with sorafenib therapy arm.
Extra data:
Laura A. Dawson et al, Stereotactic Physique Radiotherapy vs Sorafenib Alone in Hepatocellular Carcinoma, JAMA Oncology (2024). DOI: 10.1001/jamaoncol.2024.5403
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NRG Oncology
Quotation:
Including SBRT to systemic remedy may enhance outcomes for some regionally superior hepatocellular carcinoma sufferers (2024, December 19)
retrieved 19 December 2024
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