Outcomes with sorafenib (SOR) followed by regorafenib (REG) or placebo (PBO) for hepatocellular carcinoma (HCC): Results of the international, randomized phase 3 RESORCE trial.

Authors

null

Richard S. Finn

David Geffen School of Medicine at UCLA, Los Angeles, CA

Richard S. Finn , Philippe Merle , Alessandro Granito , Yi-Hsiang Huang , Gyorgy Bodoky , Marc Pracht , Osamu Yokosuka , Olivier Rosmorduc , René Gerolami , Chiara Caparello , Roniel Cabrera , Charissa Chang , Weijing Sun , Guohong Han , Marie-Aude Le Berre , Annette Baumhauer , Gerold Meinhardt , Jordi Bruix

Organizations

David Geffen School of Medicine at UCLA, Los Angeles, CA, Groupement Hospitalier Lyon Nord, Hepatology Unit, Lyon, France, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy, Taipei Veterans General Hospital, Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, St Laszlo Teaching Hospital, Budapest, Hungary, Service d'Oncologie Medicale, Centre Eugène Marquis, Rennes, France, Chiba University, Chiba, Japan, Hopital de la Pitie-Salpétrière, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie, Sorbonne Universités, Paris, France, CHU Timone, Universite de la Mediterranee, Marseille, France, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy, University of Florida Hepatology Research at CTRB, Gainesville, FL, Mount Sinai Medical Center, New York, NY, University of Pittsburgh Cancer Institute, UPMC Cancer Pavilion, Pittsburgh, PA, The First Affiliated Hospital of the Fourth Military Medical University, Xi'an, China, Bayer HealthCare SAS, Loos, France, Bayer Pharmaceuticals, Bayer Vital GmbH, Leverkusen, Germany, Bayer HealthCare Pharmaceuticals, Whippany, NJ, BCLC Group, Liver Unit, Hospital Clinic, University of Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain

Research Funding

Pharmaceutical/Biotech Company

Background: SOR is standard first-line systemic treatment for HCC unsuitable for locoregional therapy. RESORCE showed that REG improves overall survival (OS) in patients who progressed during SOR treatment (HR 0.63, 95% CI 0.50, 0.79; P < 0.001). This exploratory analysis describes outcomes for the sequence of SOR followed by REG. Methods: 573 patients were randomized 2:1 to receive REG 160 mg/day (d), 3 wks on/1 wk off or PBO. Data on prior SOR treatment and radiologic progression were prospectively collected. Efficacy and safety were evaluated by the last SOR dose. Time from the start of SOR to death was assessed. Results: Baseline characteristics were balanced. Times from the start of SOR to progression on SOR and times from progression on SOR to start of study drug were similar (Table). When analyzed based on last SOR dose 800 mg/d vs < 800 mg/d, rates of all grade treatment-emergent adverse events (TEAEs) on study were similar (REG: 100% vs 100%; PBO: 92% vs 93%). TEAE grades 3/4/5 by last SOR dose 800 mg/d vs < 800 mg/d were 52/11/15% vs 61/10/12%, respectively, with REG and 30/8/24% vs 32/7/14% with PBO. HRs (95% CI) REG/PBO for OS by last SOR dose were similar: 0.67 (0.51, 0.87) for 800 mg/d and 0.68 (0.48, 0.97) for < 800 mg/d. Median OS (95% CI) from the start of SOR was 26.0 months (22.6, 28.1) for REG and 19.2 months (16.3, 22.8) for PBO. Clinical trial information: NCT01774344Conclusions: This exploratory subgroup analysis by prior SOR dose demonstrates a consistent survival benefit for REG. In addition, the safety profile of REG was not remarkably different when analyzed by the last SOR dose.

REG
(n = 379)
PBO
(n = 194)
Duration of SOR treatment (months)
    Median (IQR)7.8 (4.2–14.5)7.8 (4.4–14.7)
    Mean (SD)11.6 (11.3)11.5 (10.7)
Months from start of SOR to progression on SOR, median (95% CI)7.1 (6.0, 8.0)7.1 (5.8, 8.7)
Months from start of SOR to start of study drug, mean (SD)12.7 (11.3)12.5 (10.7)
Months from progression on SOR to start of study drug, mean (SD)1.8 (1.4)1.8 (1.7)
Months from last dose of SOR to start of study drug, mean (SD)1.0 (0.5)1.0 (0.5)
Last SOR dose 800 mg/d60%60%
Median OS by last SOR dose, months (95% CI)
    800 mg/d10.6 (8.1, 12.6)7.0 (5.3, 9.0)
    < 800 mg/d10.6 (7.4, 14.0)8.5 (5.6, 10.0)

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Abstract Details

Meeting

2017 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Cancers of the Pancreas, Small Bowel and Hepatobiliary Tract

Track

Cancers of the Pancreas, Small Bowel, and Hepatobiliary Tract

Sub Track

Multidisciplinary Treatment

Clinical Trial Registration Number

NCT01774344

Citation

J Clin Oncol 35, 2017 (suppl 4S; abstract 344)

DOI

10.1200/JCO.2017.35.4_suppl.344

Abstract #

344

Poster Bd #

F14

Abstract Disclosures