Selective Internal Radiotherapy vs. Sorafenib for Hepatocellular Carcinoma

Sorafenib — the only approved agent for first-line treatment of advanced or metastatic hepatocellular carcinoma (HCC) — confers limited antitumor response and short-lived disease stabilization.

Now, investigators have conducted an industry-funded, multicenter, open-label, randomized phase III trial (SARAH) to compare the efficacy and safety of sorafenib versus intrahepatic injection with selective internal radiotherapy yttrium-90 resin microspheres (SIR-Spheres) in 459 patients with HCC and liver-confined disease. Most patients were male (89%–91%) with liver disease related to alcohol (56%–62%) or hepatitis C (22%–23%), and single liver lesions were present in 43% to 46%. Patients received sorafenib or hepatic artery angiography followed 1 t…