Early decrease in α-fetoprotein, but not des-γ-carboxy prothrombin, predicts sorafenib efficacy in patients with advanced hepatocellular carcinoma

Oncology. 2011;81(3-4):251-8. doi: 10.1159/000334454. Epub 2011 Nov 23.

Abstract

Objectives: The aim of this study was to investigate the relationships between early changes in the tumor markers α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP), and antitumor response in the early period following administration of sorafenib in patients with advanced hepatocellular carcinoma (HCC).

Methods: Forty-eight advanced HCC patients were evaluated. AFP and DCP were measured at baseline, and after 2 and 4 weeks, and the antitumor responses were evaluated according to the RECIST criteria 4 weeks after starting sorafenib therapy. The ratios of each tumor marker were compared by stratifying the patients into the partial response (PR) + stable disease (SD) group or the progressive disease (PD) group.

Results: Both 2 and 4 weeks after starting sorafenib therapy, the AFP ratio in the PR + SD group (n = 32) was significantly lower than in the PD group (n = 16; p = 0.002, p = 0.002). DCP was elevated in both the PR + SD group and the PD group 2 weeks and 4 weeks after starting sorafenib therapy.

Conclusions: Evaluation of AFP ratios 2 and 4 weeks after starting sorafenib therapy may be useful for predicting antitumor response. On the other hand, early elevation of DCP does not necessarily suggest treatment failure by sorafenib, as DCP elevation can occur despite therapeutic efficacy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antineoplastic Agents / therapeutic use
  • Benzenesulfonates / therapeutic use*
  • Biomarkers / blood*
  • Biomarkers, Tumor / blood*
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / pathology
  • Disease Progression
  • Female
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / pathology
  • Male
  • Niacinamide / analogs & derivatives
  • Phenylurea Compounds
  • Protein Precursors / blood*
  • Prothrombin
  • Pyridines / therapeutic use*
  • Sorafenib
  • alpha-Fetoproteins / metabolism*

Substances

  • AFP protein, human
  • Antineoplastic Agents
  • Benzenesulfonates
  • Biomarkers
  • Biomarkers, Tumor
  • Phenylurea Compounds
  • Protein Precursors
  • Pyridines
  • alpha-Fetoproteins
  • Niacinamide
  • acarboxyprothrombin
  • Prothrombin
  • Sorafenib