SHARP: sorafenib in advanced hepatocellular carcinoma
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.
Overview
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.
Median 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.
- Median overall survival 10.7 vs 7.9 months; hazard ratio 0.69.
- Time to radiological progression 5.5 vs 2.8 months.
Sorafenib became the reference standard against which lenvatinib, atezolizumab-bevacizumab and durvalumab-tremelimumab were tested, and remains an option where immunotherapy is unsuitable.
- Benefit confined to patients with good liver function.
- Very low response rate; benefit is disease stabilisation.
Similar pages
not linked directly; found by shared links- Key paperREFLECT: lenvatinib versus sorafenib in first-line treatment of unresectable hepatocellular carcinoma
Shares Sorafenib, Advanced hepatocellular carcinoma (BCLC C).
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- TrialREFLECT
Shares Sorafenib, Advanced hepatocellular carcinoma (BCLC C).
- Key paperIMbrave150: atezolizumab plus bevacizumab replaces sorafenib as first treatment for advanced liver cancer
Shares Advanced hepatocellular carcinoma (BCLC C), New England Journal of Medicine.