Using prognostic and predictive clinical features to make personalised survival prediction in advanced hepatocellular carcinoma patients undergoing sorafenib treatment

Sarah Berhane, Richard Fox, Marta García-Fiñana, Alessandro Cucchetti, Philip Johnson

Research output: Contribution to journalArticlepeer-review

10 Citations (Scopus)
55 Downloads (Pure)

Abstract

BACKGROUND: Sorafenib is the current standard of care for patients with advanced hepatocellular carcinoma (aHCC) and has been shown to improve survival by about 3 months compared to placebo. However, survival varies widely from under three months to over two years. The aim of this study was to build a statistical model that allows personalised survival prediction following sorafenib treatment.

METHODS: We had access to 1130 patients undergoing sorafenib treatment for aHCC as part of the control arm for two phase III randomised clinical trials (RCTs). A multivariable model was built that predicts survival based on baseline clinical features. The statistical approach permits both group-level risk stratification and individual-level survival prediction at any given time point. The model was calibrated, and its discrimination assessed through Harrell's c-index and Royston-Sauerbrei's R2D.

RESULTS: The variables influencing overall survival were vascular invasion, age, ECOG score, AFP, albumin, creatinine, AST, extra-hepatic spread and aetiology. The model-predicted survival very similar to that observed. The Harrell's c-indices for training and validation sets were 0.72 and 0.70, respectively indicating good prediction.

CONCLUSIONS: Our model ('PROSASH') predicts patient survival using baseline clinical features. However, it will require further validation in a routine clinical practice setting.

Original languageEnglish
Pages (from-to)117-124
Number of pages8
JournalBritish Journal of Cancer
Volume121
Issue number2
DOIs
Publication statusPublished - 11 Jun 2019

Bibliographical note

Berhane, Sarah Fox, Richard Garcia-Finana, Marta Cucchetti, Alessandro Johnson, Philip eng Research Support, Non-U.S. Gov't England Br J Cancer. 2019 Jul;121(2):117-124. doi: 10.1038/s41416-019-0488-4. Epub 2019 Jun 11.

Keywords

  • Adult
  • Aged
  • Antineoplastic Agents/therapeutic use
  • Carcinoma, Hepatocellular/drug therapy
  • Female
  • Humans
  • Liver Neoplasms/drug therapy
  • Male
  • Middle Aged
  • Prognosis
  • Sorafenib/adverse effects

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