Hand-foot skin reaction (HFSR) and overall survival (OS) in the phase 3 RESORCE trial of regorafenib for treatment of hepatocellular carcinoma (HCC) progressing on sorafenib.

Authors

null

Jordi Bruix

BCLC Group, Liver Unit, Hospital Clinic, University of Barcelona, CIBEREHD, IDIBAPS, Barcelona, Spain

Jordi Bruix , Philippe Merle , Alessandro Granito , Yi-Hsiang Huang , Gyorgy Bodoky , Osamu Yokosuka , Olivier Rosmorduc , Valeriy Vladimirovich Breder , René Gerolami , Gianluca Masi , Paul J. Ross , Shukui Qin , Tianqiang Song , Jean-Pierre Bronowicki , Isabelle Ollivier-Hourmand , Masatoshi Kudo , Lei Xu , Annette Baumhauer , Gerold Meinhardt , Guohong Han

Organizations

BCLC Group, Liver Unit, Hospital Clinic, University of Barcelona, CIBEREHD, IDIBAPS, Barcelona, Spain, Groupement Hospitalier Lyon Nord, Hepatology Unit, Lyon, France, Department of Medical and Surgical Sciences, University of Bologna, S. Orsola-Malpighi Hospital, Bologna, Italy, Division of Gastroenterology and Hepatology, Taipei Veterans General Hospital; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, St. Laszlo Teaching Hospital, Budapest, Hungary, Department of Gastroenterology and Nephrology, Chiba University, Chiba, Japan, Department of Hepatology, Hôpital de la Pitié-Salpétrière, Assistance Publique-Hôpitaux de Paris and Université Pierre et Marie Curie, Sorbonne Universités, Paris, France, Russian Cancer Research Center n.a.N.Blokhin, Moscow, Russian Federation, CHU Timone, Université de la Méditerranée, Marseille, France, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy, King's College Hospital NHS Foundation Trust, London, United Kingdom, Chinese People’s Liberation Army Cancer Center of Nanjing Bayi Hospital, Nanjing, China, Tianjin Medical University Cancer Hospital, Tianjin, China, INSERM 954, CHU de Nancy, Université de Lorraine, Nancy, France, Service d’Hépatogastroentérologie, CHU, Caen, France, Kindai University Faculty of Medicine, Osaka, Japan, Bayer HealthCare Pharmaceuticals, Inc., Whippany, NJ, Bayer Pharmaceuticals, Bayer Vital GmbH, Leverkusen, Germany, Department of Liver Disease and Digestive Interventional Radiology, National Clinical Research Center for Digestive Disease, Xijing Hospital of Digestive Diseases, Xijing Hospital, Fourth Military Medical University, Xi'an, China

Research Funding

Pharmaceutical/Biotech Company

Background: Skin toxicity is a known adverse effect of multikinase inhibitors, and was shown to be a predictor of OS in patients (pts) with HCC treated with sorafenib (Reig M, 2014). In the RESORCE trial, regorafenib improved OS versus placebo in pts with HCC progressing on sorafenib (HR 0.62, 95% CI 0.50, 0.78; Bruix J, 2017). This retrospective analysis explored whether HFSR with regorafenib was associated with OS in RESORCE. Methods: Pts in RESORCE who were randomized to regorafenib 160 mg/day during the first 3 weeks of each 4-week cycle were divided into subgroups based on whether or not they had HFSR. Estimates of OS (95% CI) were calculated using the Kaplan–Meier method. Pts who were randomized, but not treated, were included in the no HFSR group for the analysis of survival. Results: Of 379 pts randomized, 374 received at least one dose of regorafenib. Of the treated pts, 53% (n = 199) had HFSR of any grade and 13% (n = 47) had grade 3 HFSR. Among pts with HFSR at any time during the study, 77% (n = 153) had the first HFSR event (any grade) during Cycle 1. Subgroups of pts with and without HFSR at any time had some imbalances in baseline characteristics (Table). OS was improved in pts who had HFSR at any time versus those who did not (Table). Pts who had a HFSR event during Cycle 1 also had improved OS versus those who did not (median OS 13.2 vs 8.5 months; HR 0.66, 95% CI 0.51, 0.86). Conclusions: In this post-hoc exploratory analysis, HFSR with regorafenib was associated with improved OS, as was previously shown for sorafenib. The potential confounding influence of baseline factors requires further investigation. Clinical trial information: NCT01774344

HFSR
(any grade; n = 199)
No HFSR (n = 180)
Median age, yrs (range)61 (21–84)65 (19–85)
Geographic region Asia/rest of world, %50/5024/76
ECOG performance status 0/1, %75/2554/46
BCLC stage A/B/C, %*1/17/830/11/89
AFP ≥400 ng/mL, %4046
Macrovascular invasion (MVI), %2435
Extrahepatic disease (EHD), %6872
MVI and/or EHD, %7783
Child–Pugh score 5/6/7, %76/22/251/47/1†
Median OS, months (95% CI)14.1 (11.7, 16.5)6.6 (5.0, 8.5)
    HR (95% CI)0.52 (0.40, 0.67)

*Numbers may not sum to 100 due to rounding; †Child–Pugh score missing in 1 pt.

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Abstract Details

Meeting

2018 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 36, 2018 (suppl 4S; abstr 412)

DOI

10.1200/JCO.2018.36.4_suppl.412

Abstract #

412

Poster Bd #

K5

Abstract Disclosures