Lenvatinib with or without immune checkpoint inhibitors for patients with unresectable hepatocellular carcinoma in real-world clinical practice.

Abstract

BACKGROUND:

Lenvatinib is regarded as the first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of lenvatinib with or without immune checkpoint inhibitors (ICIs) in patients with unresectable HCC.

METHODS:

In this multicentric retrospective study, patients with unresectable HCC who treated with lenvatinib with or without ICIs would be enrolled. Overall survival, progression-free survival, objective response rate, and disease control rate were calculated to assess the antitumor response.

RESULTS:

Between January 2019 and August 2020, 65 patients received lenvatinib plus ICIs while other 45 patients received lenvatinib. The baseline characteristics were comparable between the two groups. Lenvatinib plus ICIs provided significantly higher overall survival (hazard ratio = 0.47, 95% CI 0.26-0.85; p = 0.013) and progression-free survival (hazard ratio = 0.35, 95% CI 0.20-0.63; p < 0.001) than lenvatinib monotherapy. Moreover, patients with lenvatinib plus ICIs had significantly higher objective response rate (41.5% vs 20.0%, p = 0.023) and disease control rate (72.3% vs 46.7%, p = 0.009) per RECIST v1.1 than those with lenvatinib. No treatment-related deaths were observed. Grade 3 or greater adverse events occurring in 10% or more of patients in either treatment group were hypertension [13 (20.0%) of 65 patients treated with lenvatinib plus ICIs vs 8 (17.8%) of 45 patients treated with lenvatinib], and palmar-plantar erythrodysesthesia [seven (10.8%) vs two (4.4%)].

CONCLUSIONS:

In this real-world study, lenvatinib combined with ICIs showed significantly promising efficacy and manageable safety than lenvatinib alone in patients with unresectable HCC.

• Authors: Kang Chen, Wei Wei, Lei Liu, Zhu-Jian Deng, Le Li, Xiu-Mei Liang, Ping-Ping Guo, Lu-Nan Qi, Zhi-Ming Zhang, Wen-Feng Gong, Shan Huang, Wei-Ping Yuan, Liang Ma, Bang-De Xiang, Le-Qun Li, Jian-Hong Zhong
• Journal: Cancer immunology, immunotherapy : CII (Cancer Immunol Immunother) Vol. 71 Issue 5 Pg. 1063-1074 (May 2022) ISSN: 1432-0851 [Electronic] Germany
• PMID: 34559308 (Publication Type: Journal Article, Multicenter Study)
• Copyright: © 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Immune Checkpoint Inhibitors
• Phenylurea Compounds
• Quinolines
• lenvatinib

Topics

• Carcinoma, Hepatocellular (pathology)
• Humans
• Immune Checkpoint Inhibitors (therapeutic use)
• Liver Neoplasms (pathology)
• Phenylurea Compounds (therapeutic use)
• Quinolines
• Retrospective Studies