{"entity":{"id":"paper-sharp-sorafenib-nejm-2008","kind":"paper","name":"SHARP: sorafenib in advanced hepatocellular carcinoma","aka":[],"tldr":"Sorafenib was the first systemic drug to lengthen survival in advanced liver cancer, adding almost three months compared with placebo, and remained the only option for a decade.","summary":"Phase 3 placebo-controlled trial of 602 patients with advanced hepatocellular carcinoma and preserved liver function (Child-Pugh A) randomised to sorafenib 400 mg twice daily or placebo.\n\nMedian overall survival was 10.7 versus 7.9 months (hazard ratio 0.69), time to radiological progression 5.5 versus 2.8 months, with response in only 2 percent; diarrhoea, weight loss and hand-foot skin reaction were the main toxicities.","asOf":"2026-09-17","links":[{"label":"N Engl J Med 2008","url":"https://doi.org/10.1056/NEJMoa0708857"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/18650514/"}],"tags":[],"related":[],"cancers":["hcc-advanced"],"sections":[],"technologies":[],"targets":[],"drugs":["sorafenib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":["sharp"],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nejm"],"dependsOn":[],"notes":[],"journal":"New England Journal of Medicine","year":2008,"doi":"10.1056/NEJMoa0708857","pmid":"18650514","authors":"Llovet JM, Ricci S, Mazzaferro V, et al.","paperType":"rct","findings":["Median overall survival 10.7 vs 7.9 months; hazard ratio 0.69.","Time to radiological progression 5.5 vs 2.8 months."],"whatItMeans":"Sorafenib became the reference standard against which lenvatinib, atezolizumab-bevacizumab and durvalumab-tremelimumab were tested, and remains an option where immunotherapy is unsuitable.","caveats":["Benefit confined to patients with good liver function.","Very low response rate; benefit is disease stabilisation."],"changedPractice":true,"participants":602},"route":"/key-papers/paper-sharp-sorafenib-nejm-2008/","neighbours":{"cancer":[{"id":"hcc-advanced","kind":"cancer","name":"Advanced hepatocellular carcinoma (BCLC C)","route":"/cancers/hcc-advanced/"}],"drug":[{"id":"sorafenib","kind":"drug","name":"Sorafenib","route":"/drugs/sorafenib/"}],"trial":[{"id":"sharp","kind":"trial","name":"SHARP","route":"/trials/sharp/"}],"journal":[{"id":"nejm","kind":"journal","name":"New England Journal of Medicine","route":"/journals/nejm/"}]}}