1. Case presented by Dr Polkinghorn
80 yo man: Active dancer, but weight loss & RUQ pain
5/10: USN = large masses in R liver  biopsy ? “NSCLC”, but nonsmoker and no lung primary
↑AFP, re-eval of pathology = HCC (K-ras wt, EGFR-neg)
Not a surgical candidate  TACE x 3
At progression, offer sorafenib, but family declines
Patient expired just last week

2. Doxorubicin plus sorafenib vs doxorubicin alone in patients with advanced hepatocellular carcinoma: a randomized trial
Abou-Alfa GK et al.
JAMA 2010;304(19):

3. Ongoing Phase III Trials: HCC - Metastatic
Study
Phase
Target Accrual
Design
Study Endpoints
CALGB 80802
III
480
(open)
Sorafenib +/- doxorubicin OS
BRISK-PS
190
Brivanib/BSC or placebo/BSC
January 2011.

4. Efficacy and Safety of Sorafenib in Patients with Advanced Hepatocellular Carcinoma: Subgroup Analyses of the SHARP and Asia-Pacific (AP) Trials by Baseline Transaminase (ALT/AST) Alpha-Fetoprotein (AFP) and Bilirubin (Bil) Levels
Raoul J et al. Proc ESMO 2010;Abstract 750P.

5. SHARP: Outcome by baseline LFTs/AFP
Population
Overall Survival (Mo) HR
SOR
PLA
All patients
10.7
7.9
0.69
No  of ALT/AST (<1.8 ULN)
11.6
8.8
0.68
Moderate  of ALT/AST (> ULN)
6.3
4.6
0.71
Normal AFP
12.4
9.5
0.76
Elevated AFP
9.4
7.0
0.72
Normal bilirubin
11.1
9.1
0.70
Elevated bilirubin
6.2
5.0
0.77
Raoul J et al. Proc ESMO 2010;Abstract 750P.

6. Case presented by Dr Polkinghorn
80 yo man: Active dancer, but weight loss & RUQ pain
5/10: USN = large masses in R liver  biopsy ? “NSCLC”, but nonsmoker and no lung primary
↑AFP, re-eval of pathology = HCC (K-ras wt, EGFR-neg)
Not a surgical candidate  TACE x 3
At progression, offer sorafenib, but family declines
Patient expired just last week 6