ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2009 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top760.jpg" width="760" height="181" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> LIVER TUMORS b) CLINICAL (EPIDEMIOLOGY, DIAGNOSIS, MANAGEMENT)<br><b>Presentation Date:</b> Apr 25, 2009</P><h2 align='left'><b>EVALUATION OF TUMOR PERFUSION AT COMPUTED TOMOGRAPHY AS A TOOL TO DETECT THE EFFECT OF SORAFENIB TREATMENT IN PATIENTS WITH HEPATOCELLULAR CARCINOMA (HCC)</b></h2> <p align='left'><b>M. Reig</b><sup>1</sup>, J. Rimola<sup>2</sup>, A. Forner<sup>1</sup>, C. Rodriguez de Lope<sup>1</sup>, J.M. Llovet<sup>1</sup>, C. Ayuso<sup>2</sup>, J. Bruix<sup>1</sup><br> <em><sup>1</sup>BCLC Group. Liver Unit, Hospital Clinic, CIBEREHD, IDIBAPS, <sup>2</sup>BCLC Group. Radiology Department, Hospital Clinic, University of Barcelona, Barcelona, Spain</em></p><br> <p align='justify'><b>Background: </b> Sorafenib (an oral tyrosine kinase inhibitor blocking the Raf/MEK/ERK pathway and VEGFR 2 and PDGFR-beta with antiproliferative and antiangiogenic effects) improves the survival of patients with advanced HCC through a delay in tumor progression. Since sorafenib does not reduce tumor burden there is a major need to develop new techniques to promptly evaluate if the drug is active and not delay the definition of failure upon detecting tumor progression. Evaluation of perfusion at computed tomography (P-CT) allows quantitative assessment of various parameters related to angiogenesis: blood flow (BF), blood volume (BV) and permeability perfusion (PP), and might be able to detect the sorafenib induced changes in tumor vascularization. <br><b>Aim: </b> To prospectively assess the feasibility of P-CT in patients with advanced HCC and to determine the specific changes associated to sorafenib treatment that ultimately may reflect its therapeutic effect. <br><b>Methods: </b> All patients considered for sorafenib therapy between October 2007 and October 2008 were recruited for the study if they had a naïve untreated target lesion. Baseline evaluation included clinical, laboratory and dynamic CT with assessment of perfusion. Same assessments were done at 3 months of therapy. <br><b>Results: </b> Thirty-three patients have been recruited and 18 of them have reached the 3 months time point. All were cirrhotics (61% HCV+), median age 67 years, 89% males., 17 Child-Pugh A, BCLC stage was B in 12 and C in 6. Mean BF and mean BV were slightly but not significantly reduced from 36.5 to 28,4 ml/min/100g tissue, and from 128,9 to 103,2ml/100g tissue. By contrast, PP (reflecting capillary permeability) significantly (p=0.002) decreased from 87, 5 to 57,5 ml/min/100g tissue. There was no baseline parameter associated to the evolution of the perfusion parameters, and the current low number of progression events impedes any robust correlation with evolutionary events. <br><b>Conclusion: </b> This preliminary study indicates that sorafenib administration is associated to changes in tissue perfusion measured at CT. Reduction in capillary permeability through a drop in PP may reflect the sorafenib action on immature tumor vessels and further follow-up will allow to define if PP becomes also a predictor of tumor evolution.</p> <br><a href='Session-Category 3b.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>