Analysis of Lenvatinib’s Efficacy against Intermediate-Stage Unresectable Hepatocellular Carcinoma
Year: 2022
Type: article
Study design: Observational Study
Abstract: Transarterial chemoembolization (TACE) has been the standard treatment for intermediate-stage, unresectable hepatocellular carcinoma (u-HCC). However, with recent advances in systemic therapy and the emergence of the concept of TACE-refractory or -unsuitable, the effectiveness of systemic therapy, as well as TACE, has been demonstrated for patients judged to be TACE-refractory or -unsuitable. In this study, the efficacy of lenvatinib and its combination with TACE after lenvatinib was investigated in 140 patients with intermediate-stage u-HCC treated with lenvatinib mainly because of being judged to be TACE-refractory or -unsuitable. Median overall survival (OS) and progression-free survival (PFS) were 24.4 and 9.0 months, respectively, indicating a good response rate. In multivariate analysis, modified albumin-bilirubin (mALBI) grade and up to seven criteria were identified as independent factors for OS, and mALBI grade and tumor morphology were identified as independent factors for PFS. While 95% of all patients were TACE-refractory or -unsuitable, the further prognosis was prolonged by the combination with TACE after lenvatinib initiation. These findings suggest that systemic therapy should be considered for intermediate-stage u-HCC, even in patients judged to be TACE-refractory or -unsuitable. The use of TACE after the start of systemic therapy may further improve prognosis.
Source: Cancers
Authors: Kei Amioka, Tomokazu Kawaoka, Takahiro Kinami, Shintaro Yamasaki, Masanari Kosaka, Yusuke Johira, Shigeki Yano, Kensuke Naruto, Yuwa Ando, Yasutoshi Fujii, Shinsuke Uchikawa, Atsushi Ono, Masami Yamauchi, Michio Imamura, Yumi Kosaka, Kazuki Ohya, Nami Mori, Shintaro Takaki, Keiji Tsuji, Keiichi Masaki, Yoji Honda, Hirotaka Kouno, Hioshi Kohno, Kei Morio, Takashi Moriya, Noriaki Naeshiro, Michihiro Nonaka, Yasuyuki Aisaka, Takahiro Azakami, Akira Hiramatsu, Hiroshi Aikata, Shiro Oka
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,513
Funders: Bristol-Myers Squibb, Eisai
OpenAlex ID: W4306367203