Sorafenib, A New Treatment for Advanced Hepatocellular Carcinoma: The Preliminary British Columbia Experience
Bibliographic record
Abstract
Objective: Hepatocellular carcinoma (HCC) is the fifth most common cancer world-wide and is a direct consequence of chronic liver disease, most commonly viral hepatitis, and cirrhosis. Current therapies for localized disease include surgical resection, locoregional radiologic interventions such as radiofrequency ablation, transarterial chemoemoblization, and in select patients, liver transplantation. Historically, systemic chemotherapy has been very disappointing and is rarely offered. Sorafenib is a new oral multi-kinase inhibitor that in the most recent piviotal clincial trial has demonstrated a survival benefit of almost 3 months over placebo. Sorafenib is now covered by the province via the British Columbia Cancer Agency and this study aims to asses the preliminary BC experience with this drug. Methods: A review was conducted of all patients referred to the British Columbia Cancer Agency with a diagnosis of hepatocellular carcinoma and we performed retrospective chart review on 30 patients who had received sorafenib. Results: Overall median survival was 7 months, similar to the placebo arm of the pivotal trial. Discontinuation of medication because of intolerability and disease progression occurred in 23 patients and only 30% were able to take 80% of the optimal dose for a median of 2.8 months. Analysis of this group revealed that the BC patients had more advanced liver disease and more were non-European compared to the clinical trial. Conclusion: These results underscore the significant differences between the perfect conditions of a clinical trial, including selection of patients, compared to the real world of clinical medicine.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".