Stereotactic Body Radiation Therapy Plus Sorafenib in Locally Advanced Hepatocellular Carcinoma

Study at a glance:

• Journal: JAMA Oncology, 2024

• Population: 177 patients with locally advanced hepatocellular carcinoma unsuitable for or refractory to local-regional therapy

• Method: Multicenter phase 3 randomized trial comparing sorafenib alone vs SBRT followed by sorafenib

• Key Finding: SBRT plus sorafenib improved progression-free survival and quality of life, with a trend toward improved overall survival

Summary:
This phase 3 randomized trial evaluated whether adding stereotactic body radiation therapy (SBRT) to sorafenib improves outcomes in patients with locally advanced hepatocellular carcinoma (HCC). A total of 177 patients were randomized. Median overall survival was 15.8 months with SBRT plus sorafenib compared to 12.3 months with sorafenib alone (HR 0.72; 95% CI, 0.52–0.99; P = .04). Median progression-free survival was significantly longer with SBRT plus sorafenib (9.2 vs 5.5 months; HR 0.55; P < .001). Rates of grade ≥3 adverse events were similar between groups (42% vs 47%). At 6 months, quality of life improved in 35% of patients with SBRT plus sorafenib compared to 10% with sorafenib alone.

Takeaway:
Adding SBRT to sorafenib improved progression-free survival and patient quality of life in advanced HCC, with a modest survival benefit and acceptable safety.

Source: Yoon SM, Lim DH, Rim CH, et al. Effect of Stereotactic Body Radiation Therapy Plus Sorafenib vs Sorafenib Alone in Patients With Locally Advanced Hepatocellular Carcinoma: A Randomized Clinical Trial. JAMA Oncol. 2024;10(9):1304-1313. doi:10.1001/jamaoncol.2024.2391. Available at: https://jamanetwork.com/journals/jamaoncology/article-abstract/2827892