Low Baseline Plasma L-Glutamine Concentration Identifies Hepatocellular Carcinoma Patients at High Risk of Developing Early Gastrointestinal Adverse Events during Sorafenib Treatment

Gastrointestinal adverse events (GIAEs) are common in patients with advanced hepatocellular carcinoma (HCC) treated sorafenib. Diarrhea is a prevalent event responsible for treatment interruptions and dosage modifications. Our study evaluates the role of baseline blood L-glutamine (L-Gln) levels prediction gastrointestinal development early during (eGIAE). Blood L-Gln was measured 135 HCC prior to starting Any developed therapy were registered prospective database. We used Mann–Whitney U Fisher’s exact tests compare quantitative or categorical variables, respectively, Kaplan–Meier method analyze time log-rank test survival functions Cox regression models estimate hazard ratios (HR). Fifteen per cent eGIAE, diarrhea as most frequent one. Patients displaying lowest presented significant higher risk while those highest protected from eGIAE achieved better survival. shows first association sorafenib treatment. Low concentrations might reflect potentially compromised intestinal barrier that becomes clinically relevant after start.