AUTHOR=Minoux Kate , Lassailly Guillaume , Ningarhari Massih , Lubret Henri , El Amrani Medhi , Canva Valérie , Truant Stéphanie , Mathurin Philippe , Louvet Alexandre , Lebuffe Gilles , Goria Odile , Nguyen-Khac Eric , Boleslawski Emmanuel , Dharancy Sebastien 

TITLE=Neo-Adjuvant Use of Sorafenib for Hepatocellular Carcinoma Awaiting Liver Transplantation

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10569

DOI=10.3389/ti.2022.10569

ISSN=1432-2277

ABSTRACT=Data on efficacy and safety of sorafenib in a neoadjuvant setting for HCC awaiting liver transplantation (LT) are heterogeneous and scarce. We aimed to investigate the trajectory of patients treated with sorafenib while awaiting LT. All patients listed for HCC and treated with sorafenib were included in a monocentric observational study. A clinical and biological evaluation was performed every month. Radiological tumor response evaluation was realized every three months on the waiting list and every six months after LT. Among 327 patients listed for HCC, 62 (19%) were treated with Sorafenib. Sorafenib was initiated for HCC progression after locoregional therapy in 50% of cases and for impossibility of other treatments in 50% of cases. The mean duration of treatment was 6 months. Thirty six patients (58%) dropped-out for tumor progression and 26 (42%) patients were transplanted. An objective radiological response was achieved in 27% of transplanted patients versus 0% of patients who dropped-out. Seven recurrences were identified after a mean follow-up of 24 months after LT. The 5-year overall and recurrent-free survivals after LT was 77% and 48% respectively. Sorafenib as neoadjuvant therapy provided access to LT in less than half candidate. Overall survival is above the current target for this indication.