Efficacy and Safety of Lenvatinib in Hepatocellular Carcinoma Patients with Liver Transplantation: A Case-Control Study

Chen, Yen‐Yang; Chen, Chao‐Long; Lin, Chih‐Che; Wang, Chih-Chi; Liu, Yueh‐Wei; Li, Weifeng; Chen, Yen‐Hao

doi:10.3390/cancers13184584

Cited by 9 publications

(10 citation statements)

References 39 publications

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“…The safety profiles of lenvatinib in patients with prior LT were consistent with the results of the REFLECT trial and other real‐world studies of lenvatinib in non‐LT HCC patients 8,13,15,31 . Although multiple immunosuppressants were used simultaneously with lenvatinib, no new safety signal was observed for lenvatinib in our study.…”

Section: Discussionsupporting

confidence: 88%

“…The safety profiles of lenvatinib in patients with prior LT were consistent with the results of the REFLECT trial and other real-world studies of lenvatinib in non-LT HCC patients. 8,13,15,31 T A B L E 3 Adverse events during lenvatinib treatment…”

Section: Discussionmentioning

confidence: 99%

“…However, patients with prior LT were excluded from prospective studies of lenvatinib. 8 , 9 , 10 As only a limited number of studies, with most including <15 patients, have been reported, 11 , 12 , 13 , 14 further investigation is required to assess the efficacy and safety of lenvatinib in patients with post‐LT HCC recurrence. Therefore, we conducted a multinational, multicenter, retrospective study of lenvatinib in patients with post‐LT HCC recurrence.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

et al. 2022

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Background: Lenvatinib is approved for patients with metastatic or recurrent hepatocellular carcinoma (HCC); however, its clinical outcomes in patients experiencing HCC recurrence after liver transplantation (LT) remain unclear. Thus, we investigated the e cacy and safety of lenvatinib in patients with recurrent HCC after LT. Methods: This multinational, multicenter, retrospective study included 45 patients with recurrent HCC after LT who received lenvatinib at six institutions in three countries (Korea, Italy, and Hong Kong) from June 2017 to October 2021.Results: At the time of lenvatinib initiation, 95.6% (n = 43) of patients were Child-Pugh A, with 35 (77.8%) and 10 (22.2%) patients classi ed as albumin-bilirubin (ALBI) grades 1 and 2, respectively. The objective response rate was 20.0%. With a median follow-up duration of 12.9 months (95% con dence interval [CI]: 11.2-14.7), median progression-free survival and overall survival (OS) were 7.6 (95% CI: 5.3-9.8) months, and 14.5 (95% CI: 0.8-28.2) months, respectively. Patients with ALBI grade 1 showed signi cantly better OS (52.3 months, [95% CI: not assessable]) than patients with ALBI grade 2 (11.1 months [95% CI: 0.0-30.4 months], p = 0.003). The most common adverse events were hypertension (n = 25, 55.6%), fatigue (n = 17, 37.8%), and anorexia (n = 14, 31.1%).Conclusion: Lenvatinib showed consistent e cacy and toxicity pro les in patients with recurrent HCC after LT compared to the results of previous studies of non-LT HCC patients. The baseline ALBI grade was correlated with better OS in lenvatinib-treated patients with LT.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

et al. 2022

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“…Several studies have confirmed the efficacy and safety of sorafenib and lenvatinib in patients with HCC [ 30 , 31 , 32 , 33 , 34 , 35 ]. Nevertheless, information on atezolizumab plus bevacizumab in real-world practice is relatively limited.…”

Section: Introductionmentioning

confidence: 99%

The Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab

Wang

Chen

Kee

et al. 2022

Cancers

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Atezolizumab plus bevacizumab has been approved as the first-line systemic treatment for patients with unresectable hepatocellular carcinoma (uHCC). This study was designed to assess the clinical impact of atezolizumab plus bevacizumab in uHCC patients. A total of 48 uHCC patients receiving atezolizumab plus bevacizumab were identified, including first-line, second-line, third-line, and later-line settings. In these patients, the median progression-free survival (PFS) was 5.0 months, including 5.0 months for the first-line treatment, not reached for the second-line treatment, and 2.5 months for the third line and later line treatment. The objective response rate and disease control rate to atezolizumab plus bevacizumab were 27.1% and 68.8%, respectively. The severity of most adverse events was predominantly grade 1–2, and most patients tolerated the toxicities. The ratios of the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) were used to predict PFS in these patients. The optimal cutoff values of NLR and PLR were 3 and 230, and NLR and PLR were independent prognostic factors for superior PFS in the univariate and multivariate analyses. Our study confirms the efficacy and safety of atezolizumab plus bevacizumab in uHCC patients in clinical practice and demonstrates the prognostic role of NLR and PLR for PFS in these patients.

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“…Given the significant morbidity and mortality associated with HCC recurrence post-LT, it is important to have a better understanding of post-LT HCC recurrence across a wide range of patient cohorts [ 12 , 13 , 14 ]. Although there are observational studies that have evaluated HCC recurrence, survival, and mortality rate after a liver transplantation, they lacked proper secondary evidence.…”

Section: Introductionmentioning

confidence: 99%

Hepatocellular Carcinoma Recurrence and Mortality Rate Post Liver Transplantation: Meta-Analysis and Systematic Review of Real-World Evidence

Bzeizi

Abdullah²,

Vidyasagar³

et al. 2022

Cancers

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Background: liver transplantation (LT) is the best curative option for eligible patients with hepatocellular carcinoma (HCC), however recurrence remains a major concern. This meta-analysis aimed to investigate the prevalence and risk factors of HCC recurrence. Methods: studies were selected using PubMed, Epistemonikas, and Google Scholar databases published from inception to 15 May 2022 and a meta-analysis of the proportions was conducted. Observational studies reporting the prevalence of recurrent HCC after an LT were included, with the analysis being stratified by an adherence to the Milan criteria (MC), geographical region, AFP levels, and donor type. Results: out of 4081 articles, 125 were included in the study. The prevalence of recurrent HCC was 17% (CI: 15–19). Patients beyond the MC were more likely to recur than patients within the MC. Asian populations had the greatest prevalence of HCC recurrence (21%; CI: 18–24), whereas North American populations had the lowest recurrence (10%; CI: 7–12). The mortality rate after HCC recurrence was 9%; CI: 8–11. North American populations had the greatest prevalence of mortality with 11% (CI: 5–17). Conclusions: the recurrence, overall survival, and mortality rates among patients with HCC post-LT remains high, with substantial differences between regions.

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Efficacy and Safety of Lenvatinib in Hepatocellular Carcinoma Patients with Liver Transplantation: A Case-Control Study

Cited by 9 publications

References 39 publications

Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

Efficacy and safety of lenvatinib in patients with recurrent hepatocellular carcinoma after liver transplantation

The Prognostic Value of Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Patients with Hepatocellular Carcinoma Receiving Atezolizumab Plus Bevacizumab

Hepatocellular Carcinoma Recurrence and Mortality Rate Post Liver Transplantation: Meta-Analysis and Systematic Review of Real-World Evidence

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