Journal Article

Reversible Decrease of Portal Venous Flow in Cirrhotic Patients: A Positive Side Effect of Sorafenib

Pol, Stanislas, Coriat, Romain, Gouya, Hervé, Vignaux, Olivier, Blanchet, Benoit, Sogni, Philippe, Chaussade, Stanislas, Goldwasser, François, Mir, Olivier, Ropert, Stanislas, Legmann, Paul

2011

Overview

Portal hypertension, the most important complication with cirrhosis of the liver, is a serious disease. Sorafenib, a tyrosine kinase inhibitor is validated in advanced hepatocellular carcinoma. Because angiogenesis is a pathological hallmark of portal hypertension, the goal of our study was to determine the effect of sorafenib on portal venous flow and portosystemic collateral circulation in patients receiving sorafenib therapy for advanced hepatocellular carcinoma. Porto-collateral circulations were evaluated using a magnetic resonance technique prior sorafenib therapy, and at day 30. All patients under sorafenib therapy had a decrease in portal venous flow of at least 36%. In contrast, no specific change was observed in the azygos vein or the abdominal aorta. No portal venous flow modification was observed in the control group. Sorafenib is the first anti-angiogenic therapy to demonstrate a beneficial and reversible decrease of portal venous flow among cirrhotic patients.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Adult / Aged / Angiogenesis / Antineoplastic agents / Antineoplastic Agents - adverse effects / Antineoplastic Agents - therapeutic use / Aorta / Benzenesulfonates - adverse effects / Benzenesulfonates - therapeutic use / Beta blockers / Carcinoma, Hepatocellular - complications / Carcinoma, Hepatocellular - drug therapy / Carcinoma, Hepatocellular - mortality / Carcinoma, Hepatocellular - pathology / Cirrhosis / Clinical trials / Complications and side effects / Disease Progression / Drug dosages / Enzyme inhibitors / Esophagus / Female / Flow alteration / Hemorrhage / Hepatocellular carcinoma / Humans / Hypertension / Hypertension, Portal - drug therapy / Hypertension, Portal - etiology / Hypertension, Portal - physiopathology / Inhibitor drugs / Liver / Liver cancer / Liver cirrhosis / Liver Cirrhosis - complications / Liver Cirrhosis - drug therapy / Liver Cirrhosis - physiopathology / Liver diseases / Liver Neoplasms - complications / Liver Neoplasms - drug therapy / Liver Neoplasms - mortality / Liver Neoplasms - pathology / Magnetic resonance / Magnetic Resonance Angiography / Male / Medicine / Metastasis / Middle Aged / Niacinamide - analogs & derivatives / NMR / Nuclear magnetic resonance / Oncology / Oxidative stress / Patients / Phenylurea Compounds / Portal Vein - drug effects / Portal Vein - physiology / Protein Kinase Inhibitors - adverse effects / Protein Kinase Inhibitors - therapeutic use / Protein-tyrosine kinase / Pyridines - adverse effects / Pyridines - therapeutic use / Regional Blood Flow - drug effects / Rodents / Survival Analysis / Targeted cancer therapy / Therapy / Tyrosine / Vascular endothelial growth factor