Beijing Delhi Trading Import and Export Company

('h', sorafenib (rb) Chinese trademark Nexavar is currently the only approved molecular targeted therapy for liver cancer, which can benefit the survival of patients with advanced hepatocellular carcinoma. There are also some clinically effective treatments for liver cancer. If there is a survival benefit for patients, can these treatment options be used in combination? Can patients gain a longer survival as a result?
' h', Nexavar+
Doxorubicin
' h', >The study aims to investigate whether doxorubicin combined with sorafenib can improve patient survival compared with sorafenib alone. The results of the study show that compared with sorafenib alone, combined with doxorubicin It cannot improve the clinical effect of sorafenib. The fundamental reason is that the toxic reactions increase accordingly when combined with doxorubicin, but the result is that no survival benefit can be obtained. A study previously published in the Journal of the American Medical Association (M) In the study, sorafenib combined with doxorubicin significantly prolonged the survival of liver cancer patients compared with doxorubicin alone, mainly due to the effect of sorafenib.
' h', > Although this study No positive results were obtained, but the significance is still important. Since most hepatocellular carcinomas are complicated by liver cirrhosis, they have poor tolerance to traditional chemotherapy and have obvious side effects. Therefore, while pursuing the remission rate in the treatment of hepatocellular carcinoma, it is more necessary to Focus on reducing toxic side effects, and the main goal of treatment is survival benefit rather than remission rate.
' h', >Due to the high toxicity of doxorubicin, previous studies did not have enough evidence to show its treatment There is a survival benefit for hepatocellular carcinoma, but the appropriateness of the study plan design using sorafenib combined with doxorubicin is questionable. Sorafenib combined with a chemotherapy regimen with less toxic effects and evidence of survival benefit may be able to obtain positive results The results.
' h', Nexavar +
Hepatic arterial chemoembolization (
)
' h', > Sorafenib as a targeted drug in the mid-to-late stage The treatment of liver cancer has a history in recent years, and some patients have benefited from it clinically. It has now entered the American guidelines and has been widely recognized by the international medical community. Hepatic arterial chemoembolization is also one of the internationally recognized effective methods for the treatment of intermediate and advanced liver cancer. Two The combined application of these methods should theoretically be more effective than a single method.
' h', >The trial is a multi-center, randomized controlled study conducted using this model. The results showed that the median number of days in the sorafenib combination group was , while the control group days (=.,.), the overall survival time of the sorafenib group and the control group is =.,.. The conclusion is that this combination cannot bring clinically meaningful prolongation of survival to patients.
' h', > So what is the reason for the failure of the trial? First of all, the timing of administration of sorafenib is too early. Sorafenib should be administered one week after DB surgery when the liver function is reexamined and is close to normal. This can ensure It can be carried out in a planned manner as needed, which can improve the local control rate of the lesions. In the trial, about 1/2 of the patients in the sorafenib group were treated only once. This may be due to the early combination of sorafenib causing damage to liver function, which in turn affects the treatment. . Secondly, the efficacy of sorafenib as a single agent in the treatment of liver cancer is low. If local lesions are not controlled through multiple treatments or combined ablation, even if it is combined with sorafenib, it will not achieve a good effect.
' h', >Special reminder
' h', >A wrong tendency in the treatment of liver cancer is to blindly pursue the negative conversion of liver cancer virus indicators. It seems that once the viral indicators of liver cancer patients turn negative, everything will be fine. In fact, this is not the case. The specific reasons will be introduced in detail in the next article Drug Shipping (Iressa India Direct Shopping Network). Drug Shipping (DU) believes that clinical attention should be paid to the positive implications under the negative appearance of the research results and the treatment measures for Nexavar's side effects.