Real World Data of Cabozantinib in Patients with Hepatocellular Carcinoma: Focusing on Dose Setting and Modification
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Aim: To investigate the outcomes of cabozantinib in patients with unresectable hepatocellular carcinoma (uHCC), focusing on dose setting and modification.
Methods: We retrospectively analyzed 34 Japanese patients who received cabozantinib for uHCC. Trough concentrations (C) of cabozantinib were also measured weekly for 6 weeks in the 18 patients.
Results: Sixteen patients received ≥40 mg (high-dose group), and 18 patients received 20 mg (low-dose group). Dose escalations were performed in 27.8% of the patients in the low-dose group. Although median duration of the first dose reduction or interruption in the low-dose group was twice that in the high-dose group (28 vs. 14 days, p < 0.001), there were no significant differences in the relative dose intensity (RDI) during 6 weeks, progression free survival (PFS), and overall survival (p = 0.162, p = 0.950, p = 0.817, respectively) between the two groups. Patients who received RDI during 6 weeks ≥33.4% showed a trend toward longer median PFS (p = 0.054). Each serum aldolase value during the 6 weeks was significantly correlated with the C at any point (r = 0.500, p < 0.001). In multivariate analyses, aldolase ≥8.7 U/L within 2 weeks was significantly associated with the very early dose reduction or interruption (odds ratio 20.0, p = 0.002).
Conclusions: An initial dose of 20 mg cabozantinib could be a safe option in Japanese patients. The serum aldolase value could be useful for making appropriate dose modifications of cabozantinib.
Okubo H, Ando H, Nakamura S, Takasaki Y, Ito K, Fukuo Y Cancer Med. 2024; 13(18):e70222.
PMID: 39315523 PMC: 11420626. DOI: 10.1002/cam4.70222.