ArticleJournal of cancer research and clinical oncology2018
Metronomic capecitabine as second-line treatment for hepatocellular carcinoma after sorafenib discontinuation.
Article in Journal of cancer research and clinical oncology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 2 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
57 citing papers in PubMed, 2 syntheses or guidelines pooled it, 77 citations in OpenAlex.
- Effectiveness of regorafenib in second-line therapy for advanced hepatocellular carcinoma: A systematic review and meta-analysis.Medicine · 2025Pooled it
- High intramuscular adipose tissue content associated with prognosis and postoperative complications of cancers.Journal of cachexia, sarcopenia and muscle · 2023Pooled it
- Effectiveness and safety of anlotinib with or without S-1 in the treatment of patients with advanced hepatocellular carcinoma in a Chinese population: a prospective, phase 2 study.Radiology and oncology · 2023Trial
- TP53, HIF1A, and CDKN2A in Hepatocellular Carcinoma: Roles in Senescence, Ferroptosis, and Prognosis.Clinical and translational gastroenterology · 2026Article
- Article
- Metronomic Capecitabine Triggers Ferroptosis in Hepatocellular Carcinoma Cells Through Inhibition of TYMS.Cancer medicine · 2026Article
- Breaking bottlenecks: the future of hepatocellular carcinoma clinical trials and therapeutic targets.Hepatology international · 2025Review
- TEAD4 Transcriptionally Activates TRIB3 to Induce Ferroptosis Resistance through the MEK/ERK Signaling Pathway in Colorectal Cancer.Gut and liver · 2025Article
- PANoptosis-associated genes exhibit significant potential in the diagnosis of hepatocellular carcinoma.Journal of gastrointestinal oncology · 2025Article
- The long noncoding RNA RMRP-miR-3135a-SV2A axis promotes the development of hepatocellular carcinoma.Journal of gastrointestinal oncology · 2025Article
- A novel prognostic framework for HBV-infected hepatocellular carcinoma: insights from ferroptosis and iron metabolism proteomics.Briefings in bioinformatics · 2025Article
- Angiogenesis Is Associated With Aggressive Biology That Counterbalances With Tumor Immunogenicity in Hepatocellular Carcinoma.World journal of oncology · 2025Article
- Comprehensive Investigation of a Tyrosine Kinase Inhibitor-Resistant GeneWorld journal of oncology · 2025Article
- A gene signature associated with cellular senescence serves as an important prognostic indicator in hepatocellular carcinoma.Translational cancer research · 2025Article
- Integrated Analysis of Bulk and Single-Cell RNA Sequencing Data Reveal a Novel Prognostic Signature of Combining Cuproptosis- and Ferroptosis-Related Genes in Hepatocellular Carcinoma.International journal of molecular sciences · 2025Article
- Article
- The future of metronomic chemotherapy: experimental and computational approaches of drug repurposing.Pharmacological reports : PR · 2025Review
- Integrating T-cell inflammation features for prognosis in hepatocellular carcinoma: a novel predictive model.Journal of gastrointestinal oncology · 2024Article
- Article
- A Case of Fibrolamellar Hepatocellular Carcinoma in Which Tumor Control Was Achieved by Re-Administering Atezolizumab and Bevacizumab.Cancer reports (Hoboken, N.J.) · 2024Article
Corrections and comments
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Authors and funding
15 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeMetronomic capecitabine (MC) is a well-tolerated systemic treatment showing promising results in one retrospective study, as second-line therapy after sorafenib failure, in patients with hepatocellular carcinoma (HCC).
methods117 patients undergoing MC were compared to 112 patients, eligible for this treatment, but undergoing best supportive care (BSC) after sorafenib discontinuation for toxicity or HCC progression. The two groups were compared for demographic and clinical features. A multivariate regression analysis was conducted to detect independent prognostic factors. To balance confounding factors between the two groups, a propensity score model based on independent prognosticators (performance status, neoplastic thrombosis, causes of sorafenib discontinuation and pre-sorafenib treatment) was performed.
resultsPatients undergoing MC showed better performance status, lower tumor burden, lower prevalence of portal vein thrombosis, and better cancer stage. Median (95% CI) post-sorafenib survival (PSS) was longer in MC than in BSC patients [9.5 (7.5-11.6) vs 5.0 (4.2-5.7) months (p < 0.001)]. Neoplastic thrombosis, cause of sorafenib discontinuation, pre-sorafenib treatment and MC were independent prognosticators. The benefit of capecitabine was confirmed in patients after matching with propensity score [PSS: 9.9 (6.8-12.9) vs. 5.8 (4.8-6.8) months, (p = 0.001)]. MC lowered the mortality risk by about 40%. MC achieved better results in patients who stopped sorafenib for adverse events than in those who progressed during it [PSS: 17.3 (10.5-24.1) vs. 7.8 (5.2-10.1) months, (p = 0.035)]. Treatment toxicity was low and easily manageable with dose modulation.
conclusionsMC may be an efficient and safe second-line systemic therapy for HCC patients who discontinued sorafenib for toxicity or tumor progression.
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