☆ 4.6 Article

Real-World Efficacy and Safety of Lenvatinib in Korean Patients with Advanced Hepatocellular Carcinoma: A Multicenter Retrospective Analysis

LIVER CANCER (2020)

Journal

LIVER CANCER

Volume 9, Issue 5, Pages 613-624

Publisher

KARGER

DOI: 10.1159/000508901

Keywords

Lenvatinib; Hepatocellular carcinoma; Liver cancer; Real-world conditions

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Abstract

Introduction/Objective: Lenvatinib demonstrated efficacy and safety in patients with advanced hepatocellular carcinoma (HCC) in the randomized phase III REFLECT trial. Considering the discrepancies in patients between clinical trial data and daily practice, an account of practical experience is needed. Methods: We conducted a multicenter retrospective analysis in which 3 tertiary referral centers participated. A total of 92 patients with advanced HCC treated with lenvatinib between September 2018 and January 2020 were analyzed. Results: Lenvatinib was used as the first-line therapy for 67 (72.8%) patients, and for 25 (27.2%) patients previously treated with other systemic therapy including immune checkpoint inhibitors. At the time of initiation of lenvatinib, 74 (80.4%) and 18 (19.6%) patients were classified as Child-Pugh A and B, respectively. Thirty-five patients (38.0%) had extensive disease that would have excluded them from the REFLECT trial. In the Child-Pugh A group, the response rate graded according to the Response Evaluation Criteria in Solid Tumors v1.1 was 21.1%, median progression-free survival (PFS) was 4.6 (95% confidence interval [CI] 3.1-6.1) months, and overall survival (OS) was 10.7 (95% CI 4.8-16.5) months for patients treated with first-line lenvatinib (n= 57). With second- or later-line lenvatinib (n= 17), median PFS and OS were 4.1 (95% CI 3.1-5.1) and 6.4 (95% CI 5.1-7.7) months, respectively. In the Child-Pugh B group (n= 18), median PFS and OS were 2.6 (95% CI 0.6-4.6) and 5.3 (95% CI 2.0-8.5) months, respectively. The most common grade 3-4 toxicities were hyperbilirubinemia (n= 8; 8.7%), AST elevation (n= 6; 6.5%), and diarrhea (n= 5; 5.4%) across all study patients. Conclusions: In this real-world study, lenvatinib was found to be well tolerated and effective in more heterogeneous HCC patient populations. (c) 2020 The Author(s) Published by S. Karger AG, Basel

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The combination treatment strategy of lenvatinib for hepatocellular carcinoma: a real-world study

Jinbin Chen, Peiyao Xiong, Man Nie, Yangxun Pan, Juncheng Wang, Dandan Hu, Zhongguo Zhou, Yaojun Zhang, Minshan Chen, Li Xu

Summary: This study found that combination therapies based on lenvatinib were associated with significantly better progression-free survival and tumor response rates than lenvatinib monotherapy in patients with unresectable hepatocellular carcinoma. Triple therapy (combined with both PD-1/PD-L1 inhibitors and local therapy) was superior to dual therapy (combined with either PD-1/PD-L1 inhibitors or local therapy) in terms of progression-free survival. However, there were more adverse events in patients receiving combination therapy and triple therapy.

JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY (2023)