Efficacy of Lenvatinib and Sorafenib in the Real-World First-Line Treatment of Advanced-Stage Hepatocellular Carcinoma in a Taiwanese Population

Lee, Shou-Wu; Yang, Sheng‐Shun; Lien, Han‐Chung; Peng, Yen‐Chun; Ko, Chung‐Wang; Lee, Teng‐Yu

doi:10.3390/jcm11051444

Cited by 13 publications

(31 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hepatocellular carcinoma (HCC) is one of the most common cancers worldwide and the fourth leading cause of cancer related mortality [ 1 ], with more than 80% of patients diagnosed at an advanced unresectable stage and curative options such as surgical resection and liver transplantation are excluded at these advanced stages, and therefore only limited effective treatment options remain [ 2 ]. Sorafenib and recently lenvatinib, have been approved as first line systemic treatment options for advanced HCC patients, as evidenced by several studies demonstrating the survival benefit of sorafenib and lenvantinib treatment [ 3 ]. The SHARP trial has demonstrated the survival benefit of sorafenib compared to placebo.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Plasma growth hormone is a potential biomarker of response to atezolizumab and bevacizumab in advanced hepatocellular carcinoma patients

et al. 2022

View full text Add to dashboard Cite

Introduction: Hepatocellular carcinoma (HCC) has limited systemic therapy options when discovered at an advanced stage. Thus, there is a need for accessible and minimally invasive biomarkers of response to guide the selection of patients for treatment. This study investigated the biomarker value of plasma growth hormone (GH) level as a potential biomarker to predict outcome in unresectable HCC patients treated with current standard therapy, atezolizumab plus bevacizumab (Atezo/Bev). Materials and Methods: Study included unresectable HCC patients scheduled to receive Atezo/Bev. Patients were followed to determine progression-free survival (PFS) and overall survival (OS). Plasma GH levels were measured by ELISA and used to stratify the HCC patients into GH-high and GH-low groups (the cutoff normal GH levels in women and men are ≤3.7 μg/L and ≤0.9 μg/L, respectively). Kaplan-Meier method was used to calculate median OS and PFS and Log rank test was used to compare survival outcomes between GH-high and -low groups. Results: Thirty-seven patients were included in this analysis, of whom 31 were males and 6 females, with a median age of 67 years (range: 37–80). At the time of the analysis, the one-year survival rate was 70% (95% CI: 0.51, 0.96) among GH low patients and 33% (95% CI: 0.16, 0.67) among GH high patients. OS was significantly superior in GH-low compared to GH-high patients (median OS: 18.9 vs. 9.3 months; p = 0.014). PFS showed a non-significant trend in favor of GH-low patients compared to the GH-high group (median PFS: 6.6 vs. 2.9 months; p = 0.053). Discussion and conclusions: Plasma GH is a biomarker candidate for predicting treatment outcomes in advanced HCC patients treated with Atezo/Bev. This finding should be further validated in larger randomized clinical trials in advanced HCC patients.

show abstract

Section: Introductionmentioning

confidence: 99%

“…The SHARP trial has demonstrated the survival benefit of sorafenib compared to placebo. In addition, lenvantinib was proven to be non-inferior to sorafenib in term of OS in the REFLECT trial [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Plasma growth hormone is a potential biomarker of response to atezolizumab and bevacizumab in advanced hepatocellular carcinoma patients

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Of the 24 studies included, one was a phase III randomized controlled trial (RCT) [ 8 ], and the other 23 were retrospective studies [ 8 , 9 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 ], involving 2438 patients with unresectable HCC who received first-line treatment with lenvatinib. The initial dose of oral lenvatinib was 12 mg QD for patients with a body weight of ≥60 kg, or 8 mg QD for those with a body weight of <60 kg.…”

Section: Resultsmentioning

confidence: 99%

“…The initial dose of oral lenvatinib was 12 mg QD for patients with a body weight of ≥60 kg, or 8 mg QD for those with a body weight of <60 kg. Of the 23 studies that assessed the tumor response, nineteen studies [ 9 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 24 , 25 , 27 , 28 , 31 , 32 , 33 , 34 , 35 ] applied the mRECIST, one [ 32 ] applied the RECIST 1.1, one [ 21 ] applied the RECIST 1.1 and mRECIST, and two [ 26 , 30 ] were unknown. Details of all studies and the characteristics of the patients are presented in Table 1 .…”

Section: Resultsmentioning

confidence: 99%

Lenvatinib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Wang

et al. 2022

Cancers

View full text Add to dashboard Cite

Lenvatinib was approved in 2018 as a first-line treatment for patients with unresectable hepatocellular carcinoma (HCC). This systematic review and meta-analysis aimed to provide the most updated evidence about the efficacy and safety of lenvatinib as a first-line treatment for unresectable HCC. An electronic search of the PubMed database, Web of Science, Embase, and Cochrane Library was undertaken to identify all relevant studies up to May 2022. The pooled effect sizes were calculated based on the random-effects model. One phase III randomized controlled trial and 23 retrospective studies of 2438 patients were eligible for analysis. For patients treated with lenvatinib as first-line treatment, the pooled median overall survival (OS), median progression-free survival (PFS), 1-year OS rate, 1-year PFS rate, objective response rate (ORR), and disease control rate (DCR) were 11.36 months, 6.68 months, 56.0%, 27.0%, 36.0% and 75.0%, respectively. Lenvatinib showed a significantly superior efficacy compared with sorafenib (HR for OS, 0.85 and HR for PFS, 0.72; OR for ORR, 4.25 and OR for DCR, 2.23). The current study demonstrates that lenvatinib can provide better tumor responses and survival benefits than sorafenib as a first-line treatment for unresectable HCC, with a comparable incidence of adverse events.

show abstract

“…Недавно были опубликованы результаты сравнительных исследований ленватиниба с сорафенибом в реальной клинической практике [31,32].…”

Section: Discussionunclassified

Lenvatinib Therapy in Patients with Unresectable Hepatocellular Carcinoma in Real Clinical Practice

Петкау

Sultanbaev

Menshikov

et al. 2022

Rossijskij žurnal gastroènterologii, gepatologii, koloproktolog

View full text Add to dashboard Cite

Aim. To determine lenvatinib treatment outcomes in patients with advanced unresectable hepatocellular carcinoma (uHCC) in real clinical practice.Patients and methods. A multicenter retrospective observational study included 58 patients with a confirmed uHCC diagnosis receiving lenvatinib. At baseline, ECOG, Child-Pugh and BCLC scores were assessed. The objective response rate (ORR), disease control rate (DCR), median overall survival (OS) and median progression-free survival (PFS) rates were assessed. In addition, adverse effects (AE) during treatment were monitored.Results. The median OS and PFS comprised 14.6 (95 % CI 10.6–18.6) and 11.1 months (95 % CI 8.31–13.8), respectively. The ORR amounted to 32.8 %, while DCR reached the level of 79.3 %. The levels of ORR and DCR were not statistically significantly different between the patients with stages B and C according to the BCLC staging system, with grades 0 and 1 according to ECOG, with classes A and B according to the Child-Pugh score, with viral and non-viral HCC etiology, with and without extrahepatic spread, and with and without portal vein invasion. Patients with alpha-fetoprotein (AFP) blood levels <200 ng/mL showed significantly higher ORR and DCR compared to those with AFP levels >200 ng/mL (44.4 % vs. 13.6 %, p = 0.015; and 88.9 % vs. 63.6 %, p = 0.021, respectively). The uHCC stage according to BCLC, ECOG functional status, Child-Pugh class, presence or absence of extrahepatic spread and viral etiology had no effect on the OS and PFS median levels. Patients with macroscopic portal vein invasion had a significantly lower PFS compared with those lacking this complication: 3.97 (0.00-8.07) vs. 11.1 (8.46-13.7), p = 0.053. AFP levels ≥200 ng/mL adversely affected survival rates: median OS comprised 12.0 (5.95-18.9) months in the group of patients with AFP ≥200 ng/mL vs. 16.1 (8.73-23.5) months in the group of patients having AFP <200 ng/mL, p = 0.020. AEs were registered in 81.0% (n = 47) of patients. Among the most common AEs were arterial hypertension (32.8 %), weakness (24.1 %), weight loss (12.1 %) and appetite loss (10.3 %). Due to AEs, Lenvatinib was withdrawn in 5 (8.6 %) patients.Conclusion. Lenvatinib confirmed its efficacy and safety in patients with uHCC in real clinical practice. The treatment outcome might be affected by AFP levels and the presence of macroscopic portal vein invasion. Further comparative studies into treatment regimens applied in real clinical practice are required.

show abstract

Efficacy of Lenvatinib and Sorafenib in the Real-World First-Line Treatment of Advanced-Stage Hepatocellular Carcinoma in a Taiwanese Population

Cited by 13 publications

References 17 publications

Plasma growth hormone is a potential biomarker of response to atezolizumab and bevacizumab in advanced hepatocellular carcinoma patients

Plasma growth hormone is a potential biomarker of response to atezolizumab and bevacizumab in advanced hepatocellular carcinoma patients

Lenvatinib as First-Line Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Lenvatinib Therapy in Patients with Unresectable Hepatocellular Carcinoma in Real Clinical Practice

Contact Info

Product

Resources

About