Journal of Cancer Therapy, 2014, 5, 1332-1343 Published Online December 2014 in SciRes. http://www.scirp.org/journal/jct http://dx.doi.org/10.4236/jct.2014.514133 How to cite this paper: Varela, M., et al. (2014) Time to Progression of AFP (TPA) as a Predictor of Survival in Hepatocellular Carcinoma Treated with Sorafenib (SOR). Journal of Cancer Therapy, 5, 1332-1343. http://dx.doi.org/10.4236/jct.2014.514133 Time to Progression of AFP (TPA) as a Predictor of Survival in Hepatocellular Carcinoma Treated with Sorafenib (SOR) Maria Varela 1* , Olegario Castaño-Fernández 1 , Marcelo Garrido 2 , Lorena Blanco-García 1 , Pablo Martínez-Camblor 3,4 , Alicia Mesa-Álvarez 5 , Carmen Navascués 1 , Valle Cadahía-Rodrigo 1 , Rafael Menéndez de Llano 5 , Ramon Pérez-Álvarez 1 , Maria Luisa González-Diéguez 1 , Manuel Rodríguez 1 1 Liver Unit, Department of Gastroenterology and Hepatology, Asturias Central University Hospital, Oviedo, Spain 2 Hemato-Oncology Department, Pontifical Catholic University of Chile, Santiago, Chile 3 Research Support Unit, Biosanitary Research Unit (OIB/Ficyt), Oviedo, Spain 4 Autonoma University of Chile, Santiago, Chile 5 Department of Radiology, Hospital Universitario Central de Asturias, Oviedo, Spain Email: * maria.varela.calvo@gmail.com , * maria.varelac@sespa.princast.es Received 22 September 2014; revised 20 October 2014; accepted 14 November 2014 Copyright © 2014 by authors and Scientific Research Publishing Inc. This work is licensed under the Creative Commons Attribution International License (CC BY). http://creativecommons.org/licenses/by/4.0/ Abstract Background: The standard therapy in advanced hepatocellular carcinoma (HCC) is sorafenib (SOR), which has the inconvenience of toxicity and discontinuation. Patient selection and the use of early markers are critical for optimizing the potential benefit of SOR. Alpha-fetoprotein (AFP) has an es- tablished role in HCC prognosis. The objective was to evaluate whether AFP variation during SOR treatment reflects the lack of progression to SOR and can be used as a prognostic factor. Methods: AFP levels were prospectively analyzed in 114 patients to determine whether the time to progres- sion of AFP (TPA) at 3 months had a prognostic value for survival. Results: Between July 2007 and October 2012, 114 patients were included (mean age 64 years, 97 male, 96 with cirrhosis). Etiology was alcohol 47 (41%) and hepatitis C virus (HCV) 31 (27%). According to the Barcelona Clinic Liver Cancer (BCLC) staging system: A (one case), B (24 cases) and C (89 cases). The Child-Pugh was Class A in 89 cases. The general condition of the patient according to ECOG-PS was 0 in 73 cases. The me- dian duration of treatment was 5 months (3.47 - 6.53, 95% CI). The median overall survival (OS) was 9.23 months. The standard dose was maintained in 26 patients (22.8%). Sixty-seven percent of patients experienced at least one adverse event grade 3-4. The time to progression of AFP lower or higher than 3 months was an independent prognostic factor of OS (univariate and multivariate analysis): 8.10 vs. 18.85 months, P < 0.001. Conclusion: HCC treated with SOR with TPA > 3 months had longer OS, and TPA was an independent prognostic factor. * Corresponding author.