Evidence map›Paper›PMID 34052255›Full record

ArticleJournal of hepatology2021

Sorafenib is associated with a reduced rate of tumour growth and liver function deterioration in HCV-induced hepatocellular carcinoma.

Ruwanthi Kolamunnage-Dona, Sarah Berhane, Harry Potts, Edward H Williams, James Tanner, Tobias Janowitz, Matthew Hoare, Philip Johnson

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed, 2 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 2 syntheses or guidelines pooled it, 23 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. [Chinese expert consensus on the use of standardized second-line drugs for primary hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  6. Review
  7. A Conserved FABP5Liver international : official journal of the International Association for the Study of the Liver · 2025
    Article
  8. Viral oncogenesis in cancer: from mechanisms to therapeutics.Signal transduction and targeted therapy · 2025
    Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. NASH and Hepatocellular Carcinoma: Immunology and Immunotherapy.Clinical cancer research : an official journal of the American Association for Cancer Research · 2023
    Review
  16. Review
  17. Article
  18. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 4 institutions in 3 countries.

Ruwanthi Kolamunnage-DonaDepartment of Health Data Science, Liverpool Health Partners, University of Liverpool, UK.
Sarah BerhaneNIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, UK; Institute of Applied Health Research, University of Birmingham, UK.
Harry PottsSchool of Clinical Medicine, University of Cambridge, Cambridge, UK.
Edward H WilliamsCRUK Cambridge Institute, University of Cambridge, Cambridge, UK.
James TannerDepartment of Radiology, University of Cambridge, Cambridge, UK.
Tobias JanowitzCRUK Cambridge Institute, University of Cambridge, Cambridge, UK; Cold Spring Harbor Laboratory, NY, USA; Northwell Health Cancer Institute, NY, USA.
Matthew HoareCRUK Cambridge Institute, University of Cambridge, Cambridge, UK; Department of Medicine, University of Cambridge, Cambridge, UK.
Philip JohnsonDepartment of Molecular and Clinical Cancer Medicine, University of Liverpool, UK. Electronic address: Philip.Johnson@liverpool.ac.uk.
University of Cambridge · GBUniversity of Liverpool · GBNorthwell Health · USUniversity Hospitals Birmingham NHS Foundation Trust · GB

Funding

Single-Cell Biology Shared ResourceP30CA045508 · NCI · COLD SPRING HARBOR LABORATORY · PI David A Tuveson · 1987 to 2026
$118.9M
Cancer Research UK 19924Cancer Research UK 24868Cancer Research UK 26813Cancer Research UK 29681Cancer Research UK C42738/A24868Medical Research Council MR/M013227/1NCI NIH HHS P30 CA045508
6 · The paper itself

Abstract

BACKGROUND &

aimsSorafenib has been the standard of care for patients with advanced hepatocellular carcinoma and although immunotherapeutic approaches are now challenging this position, it retains an advantage in HCV-seropositive patients. We aimed to quantify the rate of tumour progression in patients receiving sorafenib and relate this figure to survival, both overall, and according to viral status.

methodsUsing serial data from an international clinical trial we applied a joint model to combine survival and progression over time in order to estimate the rate of tumour growth as assessed by tumour burden and serum alpha-fetoprotein, and the impact of treatment on liver function.

resultsHigh tumour burden at baseline was associated with an increased risk of death. In patients still alive at the end of the study, the progression in relation to tumour burden was very low compared to those who died within the study. Overall, the change in mean tumour burden was 0.12 mm per day or an absolute growth rate of 3.6 mm/month. Median doubling time was 665 days. For those who progressed above 0.12 mm per day or the 12% rate, median survival was 234 days compared to 384 days if the rate was below 12%. Tumour growth rate and serum alpha-fetoprotein rise were significantly lower in those who were HCV seropositive as was the rate of decline in liver function. These results were replicated in 2 independent patient groups.

conclusionOur analysis suggests that sorafenib treatment is associated with improved survival in patients with advanced hepatocellular carcinoma mainly by decreasing the rate of tumour growth and liver function deterioration among patients with HCV infection. LAY SUMMARY: Among patients receiving sorafenib for advanced hepatocellular carcinoma the rate of tumour growth (as assessed by changes in tumour size and the biomarker alpha-fetoprotein) and the deterioration of liver function is less in those who have the hepatitis C virus, than in those who do not.

Indexed as

AdultAgedCarcinoma, HepatocellularFemaleGrowth and DevelopmentHepatitis CHumansLiverLiver Function TestsLiver NeoplasmsMaleMiddle AgedSorafenibSorafenibhepatitis C virushepatocellular carcinomajoint modellingsorafenibtumour progression rate

Identifiers

PMID34052255
PMCPMC9158473
OpenAlexW3164261791

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.