Analysis of Lenvatinib’s Efficacy against Intermediate-Stage Unresectable Hepatocellular Carcinoma

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, a...

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Published in:Cancers 2022-10, Vol.14 (20), p.5066
Main Authors: Amioka, Kei, Kawaoka, Tomokazu, Kinami, Takahiro, Yamasaki, Shintaro, Kosaka, Masanari, Johira, Yusuke, Yano, Shigeki, Naruto, Kensuke, Ando, Yuwa, Fujii, Yasutoshi, Uchikawa, Shinsuke, Ono, Atsushi, Yamauchi, Masami, Imamura, Michio, Kosaka, Yumi, Ohya, Kazuki, Mori, Nami, Takaki, Shintaro, Tsuji, Keiji, Masaki, Keiichi, Honda, Yoji, Kouno, Hirotaka, Kohno, Hioshi, Morio, Kei, Moriya, Takashi, Naeshiro, Noriaki, Nonaka, Michihiro, Aisaka, Yasuyuki, Azakami, Takahiro, Hiramatsu, Akira, Aikata, Hiroshi, Oka, Shiro
Format: Article
Language:English
Subjects:
Antigens
Bilirubin
Drug dosages
Drug therapy
Drug withdrawal
Hepatitis B
Hepatitis C
Hepatocellular carcinoma
Hepatoma
Liver cancer
Magnetic resonance imaging
Medical prognosis
Multivariate analysis
Patient outcomes
Patients
Prognosis
Survival
Tumors
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Summary: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.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers14205066