TY - JOUR
T1 - Lenvatinib as Second-Line Treatment after Atezolizumab plus Bevacizumab for Unresectable Hepatocellular Carcinoma
T2 - Clinical Results Show Importance of Hepatic Reserve Function
AU - On behalf of the Real-Life Practice Experts for HCC (RELPEC) Study Group and HCC 48 Group (hepatocellular carcinoma experts from 48 clinics in Japan)
AU - Hiraoka, Atsushi
AU - Kumada, Takashi
AU - Tada, Toshifumi
AU - Hirooka, Masashi
AU - Kariyama, Kazuya
AU - Tani, Joji
AU - Atsukawa, Masanori
AU - Takaguchi, Koichi
AU - Itobayashi, Ei
AU - Fukunishi, Shinya
AU - Tsuji, Kunihiko
AU - Ishikawa, Toru
AU - Tajiri, Kazuto
AU - Ochi, Hironori
AU - Yasuda, Satoshi
AU - Toyoda, Hidenori
AU - Ogawa, Chikara
AU - Nishimura, Takashi
AU - Hatanaka, Takeshi
AU - Kakizaki, Satoru
AU - Shimada, Noritomo
AU - Kawata, Kazuhito
AU - Naganuma, Atsushi
AU - Kosaka, Hisashi
AU - Matono, Tomomitsu
AU - Kuroda, Hidekatsu
AU - Yata, Yutaka
AU - Ohama, Hideko
AU - Tada, Fujimasa
AU - Nouso, Kazuhiro
AU - Morishita, Asahiro
AU - Tsutsui, Akemi
AU - Nagano, Takuya
AU - Itokawa, Norio
AU - Okubo, Tomomi
AU - Arai, Taeang
AU - Yokohama, Keisuke
AU - Imai, Michitaka
AU - Koizumi, Yohei
AU - Nakamura, Shinichiro
AU - Iijima, Hiroko
AU - Kaibori, Masaki
AU - Hiasa, Yoichi
N1 - Publisher Copyright:
© 2023 S. Karger AG, Basel. Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
PY - 2023/10/1
Y1 - 2023/10/1
N2 - Introduction: Lack of an established methodology for post-progression systemic treatment following atezolizumab plus bevacizumab (Atez/Bev) administration is an important clinical issue. The present study aimed to elucidate the potential of lenvatinib as a second-line treatment option after Atez/Bev failure. Methods: From 2020 to 2022, 101 patients who received lenvatinib as second-line treatment were enrolled (median 72 years, males 77, Child-Pugh A 82, BCLC-A:B:C:D = 1:35:61:4), while 29 treated with another molecular targeting agent (MTA) during the period as second-line treatment were enrolled as controls. The therapeutic efficacy of lenvatinib given as second-line treatment was retrospectively evaluated. Results: Median progression-free survival/median overall survival for all patients was 4.4/15.7 months and for those with Child-Pugh A was 4.7 months/not-reached. When prognosis was compared with patients who received another MTA, there was no significant difference for PFS (3.5 months, p = 0.557) or OS (13.6 months, p = 0.992), and also no significant differences regarding clinical background factors. mRECIST findings showed that objective response and disease control rates in patients treated with lenvatinib were 23.9% and 70.4%, respectively (CR:PR:SD:PD = 3:14:33:21), while those shown by RECIST, ver. 1.1, were 15.4% and 66.2%, respectively (CR:PR:SD:PD = 1:10:36:24). Adverse events (any grade ≥10%) were appetite loss (26.7%) (grade 1:2:3 = 2:15:10), general fatigue (21.8%) (grade 1:2:3 = 3:13:6), protein in urine (16.8%) (grade 1:2:3 = 0:4:13), and hypertension (13.9%) (grade 1:2:3 = 1:8:5). Conclusion: Although lenvatinib treatment might not provide a pseudo-combination immunotherapy effect following Atez/Bev failure, lenvatinib when used as second-line treatment after Atez/Bev failure might be expected to be comparable as compared to its use as first-line treatment.
AB - Introduction: Lack of an established methodology for post-progression systemic treatment following atezolizumab plus bevacizumab (Atez/Bev) administration is an important clinical issue. The present study aimed to elucidate the potential of lenvatinib as a second-line treatment option after Atez/Bev failure. Methods: From 2020 to 2022, 101 patients who received lenvatinib as second-line treatment were enrolled (median 72 years, males 77, Child-Pugh A 82, BCLC-A:B:C:D = 1:35:61:4), while 29 treated with another molecular targeting agent (MTA) during the period as second-line treatment were enrolled as controls. The therapeutic efficacy of lenvatinib given as second-line treatment was retrospectively evaluated. Results: Median progression-free survival/median overall survival for all patients was 4.4/15.7 months and for those with Child-Pugh A was 4.7 months/not-reached. When prognosis was compared with patients who received another MTA, there was no significant difference for PFS (3.5 months, p = 0.557) or OS (13.6 months, p = 0.992), and also no significant differences regarding clinical background factors. mRECIST findings showed that objective response and disease control rates in patients treated with lenvatinib were 23.9% and 70.4%, respectively (CR:PR:SD:PD = 3:14:33:21), while those shown by RECIST, ver. 1.1, were 15.4% and 66.2%, respectively (CR:PR:SD:PD = 1:10:36:24). Adverse events (any grade ≥10%) were appetite loss (26.7%) (grade 1:2:3 = 2:15:10), general fatigue (21.8%) (grade 1:2:3 = 3:13:6), protein in urine (16.8%) (grade 1:2:3 = 0:4:13), and hypertension (13.9%) (grade 1:2:3 = 1:8:5). Conclusion: Although lenvatinib treatment might not provide a pseudo-combination immunotherapy effect following Atez/Bev failure, lenvatinib when used as second-line treatment after Atez/Bev failure might be expected to be comparable as compared to its use as first-line treatment.
KW - Atezolizumab plus bevacizumab
KW - Child-Pugh classification
KW - Hepatocellular carcinoma
KW - Lenvatinib
KW - Modified albumin-bilirubin grade
UR - http://www.scopus.com/inward/record.url?scp=85174080546&partnerID=8YFLogxK
U2 - 10.1159/000531316
DO - 10.1159/000531316
M3 - 学術論文
C2 - 37307798
AN - SCOPUS:85174080546
SN - 0030-2414
VL - 101
SP - 624
EP - 633
JO - Oncology (Switzerland)
JF - Oncology (Switzerland)
IS - 10
ER -
