Prognostic Factor of Lenvatinib for Unresectable Hepatocellular Carcinoma in Real-world Conditions-Multicenter Analysis

Overview

Journal Cancer Med

Specialty Oncology

Date 2019 May 26

PMID 31127698

Citations 74

Authors

Atsushi Hiraoka

Takashi Kumada

Masanori Atsukawa

Masashi Hirooka

Kunihiko Tsuji

Toru Ishikawa

Koichi Takaguchi

Kazuya Kariyama

Ei Itobayashi

Kazuto Tajiri

Noritomo Shimada

Hiroshi Shibata

Hironori Ochi

Toshifumi Tada

Hidenori Toyoda

Kazuhiro Nouso

Akemi Tsutsui

Takuya Nagano

Norio Itokawa

Korenobu Hayama

Michitaka Imai

Kouji Joko

Yohei Koizumi

Yoichi Hiasa

Kojiro Michitaka

Masatoshi Kudo

Affiliations

Soon will be listed here.

Abstract

Background/aim: We assessed suitable factors indicating newly developed lenvatinib (LEN) treatment for unresectable hepatocellular carcinoma (u-HCC) by investigating real-world clinical features of patients.

Materials/methods: One hundred fifty two u-HCC patients, who receive LEN treatment from March to December 2018, were enrolled. (Child-Pugh score [CPS] 5/6/7/8 = 76/61/13/2, modified albumin-bilirubin grade [mALBI] 1/2a/2b/3 = 53/35/60/4). Clinical features were evaluated retrospectively.

Results: Overall-response rate (ORR)/disease control rate (DCR) at 1 month after starting LEN were 38.7%/86.0%, respectively. Estimated median time to progression (TTP) was 7.0 months, while median survival time was not reached within the observation period. CPS (≥7) and past history of tyrosine-kinase inhibitor (TKI) were not significant prognostic factors. mALBI ≥2b was an only significant prognostic factor (HR 4.632, 95%CI 1.649-13.02, P = 0.004) in Cox-hazard multivariate analysis. In patients with Child-Pugh A, c-index/Akaike's information criterion (AIC) of prognostic predictive value of mALBI were superior to CPS (0.682/135.6 vs 0.652/138.7), while those of stopping LEN also showed that mALBI was better (0.575/447.3 vs 0.562/447.8). Additional analysis of patients with good mALBI (1/2a) revealed that time to stopping LEN was significantly shorter in those with the adverse event (AE) of appetite loss (any grade) than those without (P = 0.006) and body mass index (BMI) was also lower in patients with that AE (20.3 ± 3.0 vs 23.6 ± 4.0kg/m , P < 0.001), while patients with a hand-foot skin reaction (any grade) showed good ORR/DCR (59.1%/86.4%) and longer TTP as compared to patients without (P = 0.007).

Conclusion: Good hepatic function (mALBI 1/2a) is the best indication for LEN, while potential appetite loss in association with low BMI should be kept in mind in such cases.

Citing Articles

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Long-Term Survival of Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib in Real-World Clinical Practice.

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Ohama H, Hiraoka A, Tada T, Hirooka M, Kariyama K, Tani J Sci Rep. 2025; 15(1):72.

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Risk factors for lenvatinib-induced hypertension in patients with hepatocellular carcinoma: A retrospective study.

Uekusa S, Nakashin M, Hanai Y, Nemoto M, Yanagino S, Arita Y Br J Clin Pharmacol. 2024; 91(3):894-902.

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Transcatheter arterial chemoembolization plus Sorafenib versus transcatheter arterial chemoembolization plus Lenvatinib for intermediate hepatocellular carcinoma.

Wang M, Cheng J, Qian N Sci Rep. 2024; 14(1):25616.

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