CHAMGAP
VERIFIEDPassed the Codex final verification and publication gate. Evidence-verification cutoff: 2026-08-26. AI was used for research and drafting; the existence of all 1 cited sources was verified at the original page, followed by blind grading, adversarial audit, and build validation. Methodology v0.8.
Verdict No. 2938 · Search date 2026-08-26 · Methodology v0.8

Everolimus,
does it really help with Improved overall survival after sorafenib failure or intolerance in advanced hepatocellular carcinoma?

30-Second Summary
D
Evidence Grade D · 34 · Safety caution
Disease control increased, but overall survival did not
Grade 3 or 4 anemia was 7.8% versus 3.3%, asthenia 7.8% versus 5.5%, and decreased appetite 6.1% versus 0.5%; stomatitis and hepatitis B reactivation were also observed. The paper presented these safety comparisons descriptively.
What the
research shows
Grade D. In EVOLVE-1, median overall survival was 7.6 versus 7.3 months, with 303/362 (83.7%) versus 151/184 (82.1%) deaths; HR 1.05 (95% CI 0.86 to 1.27; P=.68). Disease control of 56.1% versus 45.1% (P=.01) was secondary after the primary survival endpoint failed.
What the
ads claim
Tumor response or disease control must not be described as overall survival. The claim that patients lived longer failed.
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Useful facts when choosing a product

  • Everolimus 7.5 mg daily plus best supportive care was compared with placebo.
  • All-grade stomatitis occurred in 39.6% versus 4.9%.
  • Central laboratory testing found asymptomatic hepatitis B reactivation in 29 versus 10 patients, with three everolimus discontinuations.
Gap Measurement · Verdict 2938 · D 34
What advertising claims
What independent, higher-quality research supports
△ GAP
01

What the research actually shows

EVOLVE-1 assigned 546 Child-Pugh A patients with advanced HCC after sorafenib failure or intolerance in a 2:1 ratio. Novartis Pharmaceuticals sponsored the trial, participated in design, collected data through its system, used its statistical team for analysis, and had employee authors involved in interpretation, writing, and submission. Novartis also paid ApotheCom and supplied study drug and placebo. Axis 6 B0 evidence ① Allocation concealment: patients were "registered using an interactive voice- or web-response system" that randomly allocated treatment. ② Masking: the trial was "randomized, double-blind" and used matching placebo. ③ Analysis and missingness: all 546 randomized patients were "included in the full analysis population". ④ Prespecified primary endpoint: "The primary end point was overall survival" — consistent with NCT01035229

02

Why this is classified as D (34)

A well-conducted large hard-outcome trial had a null primary survival endpoint, giving D with 34 points. It was one manufacturer-sponsored trial and the interval retained possible benefit.

Counterpoint. The 11-point disease-control difference is real but does not reverse failed survival.

Rejudgment record. Cross-check applied — The prespecified primary overall-survival result in EVOLVE-1

Scoring profile behind this grade
EndpointHHard endpoint - actual events such as death
ReplicationR1Single confirmatory trial
IndependenceI0Evidence comes only from manufacturer studies
Effect sizeE0Null
PrecisionC0The confidence interval leaves room for benefit

The scoring table and the verdict agree (D).

Sub-claim grades by effect

This ingredient is marketed for several effects. A single overall grade blends strong and weak claims together, so each effect is graded separately here. The overall grade reflects the strongest disconfirming or core claim.

Effect (sub-claim)GradeBasis
Improved overall survivalDThe result was null, HR 1.05, P=.68.
Increased disease controlCIt was 56.1% versus 45.1%, but secondary after failed primary survival.

Cross-check — AI research and Codex final gate

AI was used for research and drafting. Blind grading, adversarial audit, and the methodology boundary rules were then reapplied before Codex performed the final evidence, grade, copy, and build checks. If a grade cannot be narrowed, both evidence positions and their reasons are published.
03

Evidence Table

StudyDesignSampleFundingEndpointResultWeight
Study 1Randomized double-blind placebo-controlled phase 3 trial at 121 centers in 17 countries184Novartis Pharmaceuticals sponsorship, drug and placebo supply, data management, statistical analysis, and writing supportPrimary overall survivalMedian OS 7.6 vs 7.3 months; 303/362 vs 151/184 deaths; HR 1.05 (95% CI 0.86-1.27), P=.68Pivotal large null hard-outcome evidence
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Receipt — 1 References

All 1 cited sources were verified for existence at the original page (as of 2026-08-26).

Zhu AX, Kudo M, Assenat E, et al. Effect of everolimus on survival in advanced hepatocellular carcinoma after failure of sorafenib: the EVOLVE-1 randomized clinical trial. JAMA. 2014;312:57-67. PMID: 25058218.
checked
Research and draft: AI used · Cross-check: blind grading and adversarial audit
Final verification and publication gate: Codex · Verification cutoff: 2026-08-26 · Corrections: none

Cite this verdict

No Benefit of Everolimus for Overall Survival After Sorafenib Failure in Advanced Hepatocellular Carcinoma Evidence Grade D card
[Chamgap] No Benefit of Everolimus for Overall Survival After Sorafenib Failure in Advanced Hepatocellular Carcinoma — Evidence Grade D·34. 1 cited sources checked. Source: https://chamgap.com/en/verdicts/liver/everolimus-after-sorafenib-advanced-hepatocellular-carcinoma-overall-survival/ · CC BY 4.0

CC BY 4.0 — free to use with attribution; do not distort grades, numbers, or verdict meaning.

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What this document does and does not do

Chamgap is an information source. It reports what research has and has not confirmed; it does not tell readers what to take or buy. That decision belongs to readers and, when needed, medical or legal professionals. This verdict reflects literature available up to the search date and may change as new research appears. Nothing here is medical advice.