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| |  Asians Frequently Require Sorafenib Dose Reductions for Treatment of Liver Cancer: Presented at ASCO-GI By Ric Susman SAN FRANCISCO -- January 19, 2009 -- The recommended dose of the targeted agent sorafenib is not well tolerated by Asian patients undergoing treatment for hepatocellular carcinoma, researchers reported here at the American Society of Clinical Oncology's 6th Gastrointestinal Cancers Symposium (ASCO-GI). The symposium was cosponsored by the American Gastrointestinal Association Foundation, the American Society for Radiation Oncology, and the Society of Surgical Oncology. Previous research of sorafenib in liver cancer established the effective mean daily dose to be 700 mg daily but was conducted entirely from populations in Europe, North America, and South America. To evaluate the use of sorafenib in a predominately Asian population, Kaylene Barrera, BS, University of Southern California, Los Angeles, California, conducted a retrospective analysis with David Imagawa, MD, Hepatobiliary and Pancreatic Surgery Program, UC Irvine Medical Center, Irvine, California, and other colleagues. "Hepatocellular carcinoma is the most common cancer among the Asian population," explained Barrera. Sorafenib is the first medical treatment approved by the US Food and Drug Administration for hepatocellular carcinoma. The researchers reported the study findings in a poster presentation on January 15. They performed their analysis among patients diagnosed with hepatocellular carcinoma and treated with sorafenib at a single institution between February 2007 and June 2008. In that group of patients, there were 36 Asians and 10 non-Asians. The average age of the Asian population was 65.4 years. The non-Asians in the study had a mean age of 58.4 years. Patients received a dose of 400 mg twice daily, but all but 1 of the Asian patients required dose reduction due to inability to tolerate the dose, Barrera said. At a dosage of 200 mg twice daily, 25 patients were able to tolerate the sorafenib treatment, she added. This was the highest dosage the Asian patients could tolerate, she noted. Five other Asian patients were only able to tolerate a daily dose of 200 mg; 5 patients could not tolerate any level of sorafenib therapy. "Conversely there were 4 non-Asian patients that were able to tolerate the 400-mg twice-daily dosage," Barrera said. Another 5 patients were able to tolerate 200 mg twice daily, and 1 non-Asian tolerated 400/200 mg dosing daily. The difference in tolerability of the 400-mg twice-a-day dosing between the 2 groups did reach statistical significance (P < .01), she reported. Dr. Imagawa said this research highlights the need to perform studies in specific populations. "Hepatocellular carcinoma is a far more common cancer in the Far East and sub-Saharan Africa than in the Western world." [Presentation title: Sorafenib for Treatment of Hepatocellular Carcinoma in the Asian-American Population: Does One Size Fit All? Abstract 198]
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