Real-Life Clinical Data of Lenvatinib versus Sorafenib for Unresectable Hepatocellular Carcinoma in Italy

Burgio, Valentina; Iavarone, M.; Costanzo, Giovan Giuseppe Di; Marra, Fabio; Tamburini, Emiliano; Piscaglia, Fabio; Masi, Gianluca; Celsa, Ciro; Foschi, Francesco Giuseppe; Silletta, Marianna; Amoruso, Daniela Caterina; Rimini, Margherita; Bruccoleri, Mariangela; Tortora, Raffaella; Campani, Claudia; Soldà, Caterina; Viola, Massimo; Forgione, A.; Conti, Fabio; Salani, Francesca; Catanese, Silvia; Giacchetto, C; Fulgenzi, Claudia Angela Maria; Coppola, Carmine; Lampertico, Pietro; Pellino, Antonio; Rancatore, Gabriele; Cabibbo, Giuseppe; Ratti, Francesca; Pedica, Federica; Corte, Angelo Della; Colombo, Massimo; Cobelli, Francesco De; Aldrighetti, Luca; Cascinu, Stefano; Casadei-Gardini, Andrea

doi:10.2147/cmar.s330195

Cited by 35 publications

(49 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The main toxicities that emerged from the phase III trial were hypertension (42.2%), diarrhea (38.7%), decreased appetite (34.0%), and weight loss (30.9%); PPES was reported by 26.9% of patients versus 52.4% in the group randomized to receive sorafenib (32). In clinical practice, similar adverse events were reported with a high incidence of hypertension, diarrhea, and anorexia/weight loss (33). Monitoring blood pressure and body weight from treatment initiation and educating the patient and his/her caregiver to promptly recognize any problem allow to manage these adverse events as well.…”

Section: Lesson From Thyroid Carcinoma and Hepatocellular Carcinomamentioning

confidence: 87%

Optimizing the use of lenvatinib in combination with pembrolizumab in patients with advanced endometrial carcinoma

et al. 2022

Self Cite

View full text Add to dashboard Cite

IntroductionThe combination of lenvatinib plus pembrolizumab demonstrated a relevant clinical benefit in patients with endometrial carcinoma. The safety profile was consistent with the established profiles of each drug in monotherapy, with the most frequent adverse events being hypertension, an on-target effect, hypothyroidism, diarrhea, nausea, vomiting, loss of appetite, fatigue, and weight loss.Areas coveredWe first review the rationale based on the combination of a VEGFR inhibitor and an immune checkpoint inhibitor, highlighting the main pharmacokinetic and pharmacodynamic features of lenvatinib. Next, we focus on the common adverse events associated with lenvatinib and guide how to optimally prevent, detect, and manage them, while minimizing interruptions during lenvatinib treatment.DiscussionThe side effects profile of lenvatinib is very well known, being similar across different tumor types. Most toxicities can be preventable. An appropriate, proactive, and thorough management of lenvatinib toxicities during treatment is required to maximize potential lenvatinib efficacy. Adverse events should be detected as early as possible, by both carefully monitoring the patient from lenvatinib initiation and preventing their occurrence. Patients should be followed also during treatment as some adverse events, e.g., cardiac dysfunction might appear later. Increased awareness on risk to benefit ratio among clinicians would be helpful to avoid dose interruptions or discontinuation of lenvatinib, with preferring other medical interventions and supportive care.

show abstract

Section: Lesson From Thyroid Carcinoma and Hepatocellular Carcinomamentioning

confidence: 87%

Optimizing the use of lenvatinib in combination with pembrolizumab in patients with advanced endometrial carcinoma

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…Recent real-world data including 466 patients in Italy reported the median PFS as being 9.0 and 4.9 months for the lenvatinib and sorafenib arm, respectively. Patients treated with lenvatinib showed a higher percentage of response rate (29.4% vs. 2.8%; p < 0.00001) compared with those treated with sorafenib [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Yang

Lien

et al. 2022

JCM

View full text Add to dashboard Cite

Aim: Currently, atezolizumab combined with bevacizumab is the standard first-line treatment for unresectable hepatocellular carcinoma (HCC), but lenvatinib or sorafenib are still recommended for these patients for some reasons. The aim of the study was to determine the outcomes of Taiwanese patients with advanced-stage HCC who received lenvatinib or sorafenib. Methods: Data on patients with BCLC stage C HCC who were receiving lenvatinib or sorafenib as the first-line therapy from May 2018 to August 2020 was collected. The individuals with lenvatinib and sorafenib were propensity score-matched at a ratio of 1:2. Results: A total of 22 patients with lenvatinib and 44 patients with sorafenib were enrolled. The ORR (36.4% vs. 11.4%, p = 0.023) and DCR (81.9% vs. 56.9%, p = 0.039) were both higher in the lenvatinib group compared with the sorafenib group. The median overall survival (OS) of the lenvatinib group and the sorafenib group was 9.36 months and 8.36 months, respectively. The best median OS was detected in patients receiving lenvatinib and having an objective tumor response (11.29 months), with a significant difference (p = 0.031) compared with the other groups. Conclusion: Lenvatinib, compared to sorafenib, had better ORR and DCR, but similar OS, in Taiwanese patients with advanced-stage HCC. The patients with an objective tumor response had a better OS.

show abstract

“…Second, the cancer stage at the start of TKI therapy was lower in the lenvatinib group than in the sorafenib group. Recent real‐world clinical studies and propensity score matching analysis of aHCC comparing lenvatinib and sorafenib have shown that lenvatinib treatment is more effective 17–19 . In addition, the molecular‐targeted therapy is to start as early as possible for patients who are unsuitable for TACE, although chemotherapy has been formerly introduced only after repeated TACE 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Recent real‐world clinical studies and propensity score matching analysis of aHCC comparing lenvatinib and sorafenib have shown that lenvatinib treatment is more effective. 17 , 18 , 19 In addition, the molecular‐targeted therapy is to start as early as possible for patients who are unsuitable for TACE, although chemotherapy has been formerly introduced only after repeated TACE. 11 Changes in the position of chemotherapy for HCC over time may be a limitation to the present analysis.…”

Section: Discussionmentioning

confidence: 99%

Significance of post‐progression therapy after tyrosine kinase inhibitors for advanced hepatocellular carcinoma

Yano

Yamamoto

Minami³

et al. 2022

JGH Open

View full text Add to dashboard Cite

Background and Aim: Molecular-targeted therapies such as sorafenib and lenvatinib have long been used as first-line treatment for advanced hepatocellular carcinoma (aHCC). However, adverse events or limited therapeutic effects may necessitate the change to another therapeutic option, known as post-progression therapy. To investigate the significance of post-progression therapy, we analyzed the outcomes of aHCC patients following first-line molecular-targeted therapy in a real-world study. Methods: This retrospective, multicenter study involved patients with aHCC who received sorafenib or lenvatinib as first-line therapy between January 2011 and September 2021. Results: In total, 513 patients were analyzed: 309 treated with sorafenib and 204 with lenvatinib. The overall response and disease control rates were 15 and 50%, respectively, in the sorafenib group and 30 and 75%, respectively, in the lenvatinib group (P < 0.001). Kaplan-Meier analysis revealed no significant differences in progressionfree survival and overall survival (OS) between the two treatments. Multivariate analysis revealed that fibrosis-4 index, disease control rate, post-progression therapy, and use of an immune checkpoint inhibitor (ICI) were significantly associated with OS. OS was significantly longer in patients who received post-progression therapy than in those who did not (log-rank P < 0.001). Most patients who received an ICI as post-progression therapy had previously received lenvatinib. Among lenvatinib-treated patients, OS was significantly longer in patients who received an ICI than in patients received another or no post-progression therapy (P = 0.004). Conclusion:The introduction of newer drugs for post-progression therapy is expected to prolong survival. ICI-based regimens appear to be effective after lenvatinib.

show abstract

Real-Life Clinical Data of Lenvatinib versus Sorafenib for Unresectable Hepatocellular Carcinoma in Italy

Cited by 35 publications

References 20 publications

Optimizing the use of lenvatinib in combination with pembrolizumab in patients with advanced endometrial carcinoma

Optimizing the use of lenvatinib in combination with pembrolizumab in patients with advanced endometrial carcinoma

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

Significance of post‐progression therapy after tyrosine kinase inhibitors for advanced hepatocellular carcinoma

Contact Info

Product

Resources

About