Gastric acid suppression plus sorafenib may lower survival in advanced HCC

Progression-free (PFS) and overall survival (OS) are significantly lower in patients with advanced hepatocellular carcinoma (HCC) treated with sorafenib and concomitant gastric acid suppression therapy, a recent study has found.

“Recent studies have revealed that coadministration of gastric acid suppressants reduces the efficacy of the tyrosine kinase inhibitors erlotinib and sunitinib in patients with nonsmall cell lung cancer and renal cell carcinoma, respectively,” the authors said.

A retrospective analysis was conducted to determine if the concurrent use of gastric acid suppressants and sorafenib impaired outcomes in patients with advanced HCC at a single tertiary referral unit in the UK between January 2008 and 2014. The impact of the concomitant use of gastric acid suppression and sorafenib on PFS and OS was assessed using a multivariate Cox proportional hazard model.

A total of 197 patients provided data for analysis, of which 182 could be assessed for this study. Seventy-seven (42 percent) patients received concurrent gastric acid suppression therapy.

In Cox regression analysis, the adjusted hazard ratio for the concurrent acid suppression group compared with the no acid suppression group was 5.4 (95 percent confidence interval [CI], 3.6–7.9) for PFS and 1.85 (95 percent CI, 1.3–2.6) for OS after adjusting for imbalances between groups.

“This is the first time that this negative interaction has been reported and further prospective validation is warranted,” the authors said.