Egyptian Liver Journal (Aug 2025)
Sorafenib-treated hepatocellular carcinoma with or without prior direct-acting antiviral therapy for hepatitis C: outcomes and survival
- Rania Lithy,
- Mohamed Kohla,
- Hossam Dabees,
- Hend Ibrahim Shousha,
- Ehab Fawzy,
- Eman M. F. Barakat,
- Mohamed El-Kassas,
- Mona Shoukry Aziz,
- Eman Elkhateeb,
- Ashraf Omar Abdelaziz,
- Mohamed Omar Abdelmalek,
- Ali Azmy,
- Ahmed Tawheed,
- Reem Abdelghafour,
- Hossam Taha,
- Mohamed Mahmoud Nabeel,
- Mohamed A. Medhat,
- Dalia Ghoraba,
- Hamdy Sayed,
- Anwar Nassief,
- Mostafa Elhelbawy,
- Tamer Elbaz,
- Ahmed Radwan,
- Safaa Ragab Askar,
- Eman Marwan,
- Eman Rewisha,
- Ahmed Hosni Abdelmaksoud,
- Sayed Hassan Ahmed,
- Nevien Fouad Elfouly,
- Nermeen Abdeen,
- Ahmed Ramadan,
- Asmaa A. Abdeltawab,
- Mostafa Abd Alfattah Shamkh,
- Yasser Arafat Abdelrazek,
- Ammar Alrajhi,
- Sayed Ahmed Sayed,
- Ahmed A. Sleem,
- Rasha Salah Hussein,
- Allam Elsayed Allam,
- Omnia A. Seyam,
- Mohamed Said,
- representing The Egyptian Network for the Study of H. C. C. (ENSH) group
Affiliations
- Rania Lithy
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Mohamed Kohla
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University
- Hossam Dabees
- National Medical Institute of Damanhour
- Hend Ibrahim Shousha
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Ehab Fawzy
- Department of Tropical Medicine and Gastroenterology, Assiut University
- Eman M. F. Barakat
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Mohamed El-Kassas
- Endemic Medicine Department, Faculty of Medicine, Helwan University
- Mona Shoukry Aziz
- National Medical Institute of Damanhour
- Eman Elkhateeb
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University
- Ashraf Omar Abdelaziz
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Mohamed Omar Abdelmalek
- Department of Tropical Medicine and Gastroenterology, Assiut University
- Ali Azmy
- Department of Medical Oncology and Nuclear Medicine, Ain Shams University
- Ahmed Tawheed
- Endemic Medicine Department, Faculty of Medicine, Helwan University
- Reem Abdelghafour
- National Medical Institute of Damanhour
- Hossam Taha
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University
- Mohamed Mahmoud Nabeel
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Mohamed A. Medhat
- Department of Tropical Medicine and Gastroenterology, Assiut University
- Dalia Ghoraba
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Hamdy Sayed
- Endemic Medicine Department, Faculty of Medicine, Helwan University
- Anwar Nassief
- National Medical Institute of Damanhour
- Mostafa Elhelbawy
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University
- Tamer Elbaz
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Ahmed Radwan
- Department of Tropical Medicine and Gastroenterology, Assiut University
- Safaa Ragab Askar
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Eman Marwan
- Endemic Medicine Department, Faculty of Medicine, Helwan University
- Eman Rewisha
- Hepatology and Gastroenterology Department, National Liver Institute, Menoufia University
- Ahmed Hosni Abdelmaksoud
- Diagnostic and Interventional Radiology Department, Cairo University
- Sayed Hassan Ahmed
- Diagnostic and Interventional Radiology, Faculty of Medicine, Assiut University
- Nevien Fouad Elfouly
- National Center for Radiation Research and Technology, Egyptian Atomic Energy Authority
- Nermeen Abdeen
- Tropical Medicine Department, Alexandria University
- Ahmed Ramadan
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Asmaa A. Abdeltawab
- Oncology Department, Faculty of Medicine, Assiut University
- Mostafa Abd Alfattah Shamkh
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Yasser Arafat Abdelrazek
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Ammar Alrajhi
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- Sayed Ahmed Sayed
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Ahmed A. Sleem
- Hepatoma Group, Tropical Medicine Department, Ain Shams University
- Rasha Salah Hussein
- Diagnostic and Interventional Radiology Department, Ain Shams University
- Allam Elsayed Allam
- Diagnostic and Interventional Radiology Department, Ain Shams University
- Omnia A. Seyam
- Diagnostic and Interventional Radiology Department, Ain Shams University
- Mohamed Said
- Endemic Medicine and Hepato-Gastroenterology Department, Cairo University
- representing The Egyptian Network for the Study of H. C. C. (ENSH) group
- DOI
- https://doi.org/10.1186/s43066-025-00448-6
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 11
Abstract
Abstract Background Hepatitis C virus (HCV) has been linked to lower tumor growth rates, higher sorafenib efficacy, and greater survival of patients treated for hepatocellular carcinoma (HCC). In real-world settings, we tried to elucidate the effectiveness of sorafenib therapy for patients with HCV-related HCC with previous direct-acting antiviral (DAAs) therapy or not. Methods This retrospective multicenter work recruited participants with sorafenib-treated HCC with and without previous DAAs therapy from November 2016 to April 2023 and followed up until death or the study end in April 2024. We compared the patients’ clinico-laboratory, imaging variables, and overall survival (OS). Results This work included 622 patients; 535 patients received DAAs before the development of HCC (group I), and 87 patients did not (group II). Group II patients showed higher rates of nausea, vomiting, and diarrhea than group I patients, while group I patients experienced higher rates of jaundice during sorafenib therapy. None of the patients achieved complete response (CR) after sorafenib. Patients previously treated with DAAs were less common to show partial response (PR) (12.9% versus 23%, respectively, P-value 0.011). The disease control rate (PR + CR + stable disease (SD)) was 45% in group I and 52.9% in group II. Group I had a considerably reduced median survival rate. The patients with SVR prior to HCC development had a median OS that was significantly lower than both non-responder patients (285.00 versus 629.00 days, respectively, P-value < 0.001) and patients without DAAs (285.00 versus 580.00 days, respectively, P-value < 0.001). Conclusion DAAs therapy before the onset of HCC might be linked to lower rates of response to sorafenib compared to DAAs-naïve patients. Furthermore, it might be connected to a decreased overall survival rate in patients treated with sorafenib.
Keywords
