Impact of Post-progression Survival on Outcomes of Lenvatinib Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Retrospective Cohort Study

Tajiri, Kazuto; Tokimitsu, Yoshiharu; Kawai, Kengo; Motofuji, Yuchi; Shinno, Eiji; Kashii, Yoshiro; Muraishi, Nozomu; Murayama, Aiko; Hayashi, Yuka; Minemura, Masami; Takahara, Taro; Shimizu, Yukihiro; Yasuda, Ichiro

doi:10.21873/anticanres.16112

Cited by 2 publications

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“…In patients receiving sorafenib treatment, which was the first TKI to show OS benefit for advanced HCC, PFS/TTP was moderately correlated with OS ( r = 0.546), whereas PPS showed a stronger correlation with OS ( r = 0.834) [7]. Lenvatinib, which is a TKI with better antitumor response than sorafenib, also showed a moderate correlation between PFS/TTP and OS ( r = 0.514), while PPS showed a stronger correlation with OS ( r = 0.877) [33]. Sequential therapies with TKIs have been shown to have a strong positive on OS [8].…”

Section: Discussionmentioning

confidence: 99%

Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

Tajiri,

Tsukada,

Tokimitsu

et al. 2023

Oncology

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Introduction: Atezolizumab plus bevacizumab (Atez/Bev) is a standard treatment for unresectable hepatocellular carcinoma (HCC) due to its good antitumor and survival prolongation effects. Post-progression survival (PPS) has been reported to be a great contributor in the treatment with tyrosine kinase inhibitors for unresectable HCC. This study aimed to clarify the significance of progression-free survival (PFS) or PPS of Atez/Bev treatment for HCC. Methods: We analyzed the correlations of PFS and PPS with overall survival (OS) in studies of HCC patients treated with Atez/Bev and evaluated the contribution to OS in Atez/Bev treatment with patients at our institutions as clinical practice. Results: Analysis of 18 studies involving 3,752 patients treated with Atez/Bev found that PPS had a stronger correlation with OS (R2 = 0.872, p < 0.001) than did PFS (R2 = 0.605, p = 0.001). Analysis of 80 patients with unresectable HCC treated with Atez/Bev found that presence of antitumor responses during Atez/Bev was the most significant contributor to OS, and post-progression treatment after Atez/Bev also significantly contribute to OS. Conclusion: The presence of antitumor response with tumor shrinkage during Atez/Bev treatment contributes to good OS through its durable response. Atez/Bev treatment could be considered as first-line treatment for unresectable HCC. However, there is a need for optimal biomarkers for good antitumor response.

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Section: Discussionmentioning

confidence: 99%

Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

Tajiri,

Tsukada,

Tokimitsu

et al. 2023

Oncology

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“…7 In lenvatinib treatment, another MTA that is a standard first-line systemic therapy in advanced HCC, PPS was again reported to be better related to OS than was PFS. 8 In treatment with MTAs for unresectable HCC, sequential therapies, sorafenib followed by regorafenib (REG), were shown to contribute greatly to longer OS. 9 Furthermore, combination therapy ICI and MTA, atezolizumab plus bevacizumab, which is a recent standard therapy for unresectable HCC, shows more contribution of PPS to OS than that of PFS.…”

Section: Introductionmentioning

confidence: 99%

“…In sorafenib treatment, which is an approved MTA, PPS was reported to contribute to OS to a greater degree than the contribution of progression‐free survival (PFS) 7 . In lenvatinib treatment, another MTA that is a standard first‐line systemic therapy in advanced HCC, PPS was again reported to be better related to OS than was PFS 8 . In treatment with MTAs for unresectable HCC, sequential therapies, sorafenib followed by regorafenib (REG), were shown to contribute greatly to longer OS 9 .…”

Section: Introductionmentioning

confidence: 99%

Impact of post‐progression survival in second‐line treatment with molecular target agents for unresectable hepatocellular carcinoma

Tajiri,

Muraishi,

Murayama

et al. 2023

Hepatology Research

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AimSequential therapies are essential to extend overall survival (OS) in patients with unresectable hepatocellular carcinoma (HCC). Several second‐line treatments with molecular target agents (MTAs) have shown survival benefits. However, the significance of post‐progression survival (PPS) in extending OS in HCC patients given such treatments remains uncertain.MethodsThrough a systematic review of the literature in the PubMed database, this study investigated the correlation between PPS and OS and that between progression free survival (PFS) and OS in HCC patients given second‐line treatments.ResultsA total of 3,935 patients who had received second‐line treatment with regorafenib, ramucirumab, or cabozantinib, which are approved MTAs, were identified. In the patients treated with regorafenib, PPS showed a strong correlation with OS (R2=0.729, R=0.854, p<0.001) whereas PFS showed a weak correlation (R2=0.218, R=0.467, p=0.021). In the patients treated with ramucirumab, PPS showed a strong correlation with OS (R2=0.800, R=0.894, p=0.016) whereas PFS showed a negligible correlation (R2=0.020, R=0.140, p=0.791). In the patients treated with cabozantinib, PPS showed a strong correlation with OS (R2=0.856, R=0.925, p=0.003) as did PFS (R2=0.946, R=0.973, p<0.001).ConclusionsPPS plays a more significant role than PFS in extending OS in patients given second‐line treatment for unresectable HCC. Sequential therapies after disease progression in second‐line treatment are essential to acquire good OS. Maintenance of hepatic reserve function and the patient’s general condition is essential during systemic treatments for unresectable HCC.This article is protected by copyright. All rights reserved.

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Impact of Post-progression Survival on Outcomes of Lenvatinib Treatment for Unresectable Hepatocellular Carcinoma: A Systematic Review and Retrospective Cohort Study

Cited by 2 publications

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Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

Objective Response and Progression-Free Survival Contribute to Prolong Overall Survival in Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma

Impact of post‐progression survival in second‐line treatment with molecular target agents for unresectable hepatocellular carcinoma

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