TY - JOUR
T1 - Evaluation of the effect of sorafenib using serum NX-des-γ-carboxyprothrombin in patients with hepatocellular carcinoma
AU - Miyahara, Koji
AU - Nouso, Kazuhiro
AU - Morimoto, Yuki
AU - Tomoda, Takeshi
AU - Kobayashi, Sayo
AU - Takeuchi, Yasuto
AU - Hagihara, Hiroaki
AU - Kuwaki, Kenji
AU - Ohnishi, Hideki
AU - Ikeda, Fusao
AU - Miyake, Yasuhiro
AU - Nakamura, Shinichiro
AU - Shiraha, Hidenori
AU - Takaki, Akinobu
AU - Yamamoto, Kazuhide
AU - Takuma, Yoshitaka
AU - Takabatake, Hiroyuki
AU - Morimoto, Youichi
AU - Fujioka, Shin Ichi
AU - Osawa, Toshiya
AU - Kariyama, Kazuya
AU - Toshimori, Junichi
AU - Kobashi, Haruhiko
AU - Miyatake, Hirokazu
AU - Iwadou, Shouta
AU - Kobayashi, Yoshiyuki
AU - Uematsu, Shuji
AU - Okamoto, Ryoichi
AU - Araki, Yasuyuki
AU - Tatsukawa, Masafumi
AU - Yabushita, Kazuhisa
AU - Shimoe, Toshinari
AU - Sakaguchi, Kohsaku
AU - Sakata, Tatsuro
AU - Kaneyoshi, Toshihiko
AU - Miyashita, Manabi
AU - Makino, Yasuhiro
AU - Moriya, Akio
AU - Ando, Masaharu
AU - Baba, Nobuyuki
AU - Seno, Tomonori
AU - Nagano, Takuya
AU - Takaguchi, Koichi
AU - Matsumoto, Eiji
AU - Takayama, Hiroki
PY - 2013/10
Y1 - 2013/10
N2 - Aim: Des-γ-carboxyprothrombin (DCP) is known to be increased by the use of sorafenib for the treatment of hepatocellular carcinoma (HCC), despite its therapeutic efficacy. In addition to the tumor progression, hypoxia that impairs vitamin K uptake is known to induce DCP and this mechanism may explain DCP elevation by sorafenib. In this study, we tried to evaluate the effect of sorafenib treatment using a new marker, NX-DCP, which is specific to vitamin K absence. Methods: Serum DCP and NX-DCP were measured in 50 consecutive HCC patients before and 1 week after starting sorafenib, and compared with the treatment effect using the modified Response Evaluation Criteria in Solid Tumors guidelines. Results: DCP and NX-DCP increased 1.58- (median, range 0.21-28.7) and 1.20-fold (median, range 0.41-14.2) after the administration of sorafenib, respectively. The increases of both markers were less than twofold in approximately half of the patients (low-elevation group). However, 12 patients showed over twofold increase of both DCP and NX-DCP (double-elevation group), and eight patients showed over twofold increase of DCP alone (DCP-elevation group). The disease control rate (DCR) of the DCP-elevation group (12.5%) was significantly lower than those of the double-elevation group (75.0%, P=0.020) and the low-elevation group (60.0%, P=0.042). Progression-free survival (PFS) was significantly shorter in the DCP-elevation group than in the double-elevation group (P=0.006) and the low-elevation group (P=0.001). Conclusion: NX-DCP in combination with DCP could be a useful biomarker of sorafenib treatment for advanced HCC.
AB - Aim: Des-γ-carboxyprothrombin (DCP) is known to be increased by the use of sorafenib for the treatment of hepatocellular carcinoma (HCC), despite its therapeutic efficacy. In addition to the tumor progression, hypoxia that impairs vitamin K uptake is known to induce DCP and this mechanism may explain DCP elevation by sorafenib. In this study, we tried to evaluate the effect of sorafenib treatment using a new marker, NX-DCP, which is specific to vitamin K absence. Methods: Serum DCP and NX-DCP were measured in 50 consecutive HCC patients before and 1 week after starting sorafenib, and compared with the treatment effect using the modified Response Evaluation Criteria in Solid Tumors guidelines. Results: DCP and NX-DCP increased 1.58- (median, range 0.21-28.7) and 1.20-fold (median, range 0.41-14.2) after the administration of sorafenib, respectively. The increases of both markers were less than twofold in approximately half of the patients (low-elevation group). However, 12 patients showed over twofold increase of both DCP and NX-DCP (double-elevation group), and eight patients showed over twofold increase of DCP alone (DCP-elevation group). The disease control rate (DCR) of the DCP-elevation group (12.5%) was significantly lower than those of the double-elevation group (75.0%, P=0.020) and the low-elevation group (60.0%, P=0.042). Progression-free survival (PFS) was significantly shorter in the DCP-elevation group than in the double-elevation group (P=0.006) and the low-elevation group (P=0.001). Conclusion: NX-DCP in combination with DCP could be a useful biomarker of sorafenib treatment for advanced HCC.
KW - Des-γ-carboxyprothrombin
KW - Hepatocellular carcinoma
KW - NX-des-γ-carboxyprothrombin
KW - Sorafenib
UR - http://www.scopus.com/inward/record.url?scp=84885025687&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84885025687&partnerID=8YFLogxK
U2 - 10.1111/hepr.12055
DO - 10.1111/hepr.12055
M3 - Article
C2 - 23347420
AN - SCOPUS:84885025687
SN - 1386-6346
VL - 43
SP - 1064
EP - 1070
JO - Hepatology Research
JF - Hepatology Research
IS - 10
ER -