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Could Sorafenib Disclose New Prospects as Bridging Therapy to Liver Transplantation in Patients with Hepatocellular Carcinoma?

Alessandro Vitale*,Freddy Salinas,Giacomo Zanus,Giuseppe Lombardi,Marco Senzolo,Francesco Russo,Umberto Cillo

Background-Aim: There are few data on the use of sorafenib as bridging therapy for patients with Hepatocellular Carcinoma (HCC) waiting for Liver Transplantation (LT). Methods: Six HCC patients were treated with sorafenib before LT at our Institution following the Italian Drug Agency guidelines: they had well compensated cirrhosis (Child-Pugh class A), intermediate stage HCC, good general conditions (performance status 0) and they were not suitable for loco-regional therapies. Results: Three patients received sorafenib until LT, whereas the other three cases required treatment discontinuation before LT. During the post-surgery period no deaths and anastomotic complications were observed. The four patients receiving Sorafenib for more than 2 months before LT were recurrence-free 27 to 41 months after surgery. Conversely, tumor recurrence leading to patient death was found in the other 2 cases. Conclusion: We think that these findings justify the start of a phase II study in a larger patient population.