Efficacy and Safety of Lenvatinib-Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma.

Abstract

INTRODUCTION:

We evaluated the efficacy and safety of lenvatinib-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy for patients (n = 88) with intermediate-stage hepatocellular carcinoma (HCC).

METHODS:

Eighty-eight patients who obtained tumor control by LEN treatment were analyzed; 30 received LEN followed by TACE (LEN-TACE sequential therapy), and 58 received LEN monotherapy. Propensity score matching was performed, and the outcomes of 19 patients in the LEN-TACE group and 19 patients in the LEN-alone group were compared. Objective response rate (ORR), progression-free survival (PFS), overall survival (OS), incidence of adverse events (AEs), and change in albumin-bilirubin (ALBI) score were evaluated.

RESULTS:

After matching, baseline characteristics were similar between the groups. The ORR was 63.2% with LEN-TACE group and 63.2% with the LEN-alone group. Multivariate analysis showed that addition of TACE during LEN treatment (hazard ratio [HR] 0.264, 95% confidence interval [CI] 0.087-0.802, p =  0.019) and Child-Pugh score 5 (HR 0.223, 95% CI 0.070-0.704, p = 0.011) were the significant factors for PFS. Median PFS was 11.6 months with LEN-TACE and 10.1 months with LEN-alone. The survival rate of the LEN-TACE group was significantly higher than that of the LEN-alone group (median survival time; not reached vs. 16.9 months, p = 0.007). The incidence of common LEN-associated AEs was similar between groups. Although elevated aspartate aminotransferase/alanine aminotransferase and fever were more frequent with LEN-TACE group, these events were manageable.

CONCLUSION:

For patients with intermediate-stage HCC, LEN-TACE sequential therapy may provide a deep response and favorable prognosis.

• Authors: Yuwa Ando, Tomokazu Kawaoka, Kei Amioka, Kensuke Naruto, Yutaro Ogawa, Yuki Yoshikawa, Chihiro Kikukawa, Yumi Kosaka, Shinsuke Uchikawa, Kei Morio, Hatsue Fujino, Takashi Nakahara, Eisuke Murakami, Masami Yamauchi, Masataka Tsuge, Akira Hiramatsu, Takayuki Fukuhara, Nami Mori, Shintaro Takaki, Keiji Tsuji, Michihiro Nonaka, Hideyuki Hyogo, Yasuyuki Aisaka, Keiichi Masaki, Yoji Honda, Takashi Moriya, Noriaki Naeshiro, Shoichi Takahashi, Michio Imamura, Kazuaki Chayama, Hiroshi Aikata
• Journal: Oncology (Oncology) Vol. 99 Issue 8 Pg. 507-517 ( 2021) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 33946070 (Publication Type: Journal Article)
• Copyright: © 2021 S. Karger AG, Basel.

Chemical References

• Antineoplastic Agents
• Phenylurea Compounds
• Quinolines
• lenvatinib

Topics

• Aged
• Aged, 80 and over
• Antineoplastic Agents (administration & dosage, adverse effects)
• Carcinoma, Hepatocellular (pathology, therapy)
• Chemoembolization, Therapeutic (adverse effects, methods)
• Cohort Studies
• Female
• Humans
• Liver Neoplasms (pathology, therapy)
• Male
• Middle Aged
• Neoplasm Staging
• Phenylurea Compounds (administration & dosage, adverse effects)
• Progression-Free Survival
• Propensity Score
• Quinolines (administration & dosage, adverse effects)
• Retrospective Studies
• Survival Rate