Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching

Toshifumi Tada; Takashi Kumada; Atsushi Hiraoka; Kojiro Michitaka; Masanori Atsukawa; Masashi Hirooka; Kunihiko Tsuji; Toru Ishikawa; Koichi Takaguchi; Kazuya Kariyama; Ei Itobayashi; Kazuto Tajiri; Noritomo Shimada; Hiroshi Shibata; Hironori Ochi; Hidenori Toyoda; Kazuhiro Nouso; Akemi Tsutsui; Takuya Nagano; Norio Itokawa; Korenobu Hayama; Michitaka Imai; Kouji Joko; Yohei Koizumi; Yoichi Hiasa

doi:10.1111/hepr.13427

Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching

Toshifumi Tada^*, Takashi Kumada, Atsushi Hiraoka, Kojiro Michitaka, Masanori Atsukawa, Masashi Hirooka, Kunihiko Tsuji, Toru Ishikawa, Koichi Takaguchi, Kazuya Kariyama, Ei Itobayashi, Kazuto Tajiri, Noritomo Shimada, Hiroshi Shibata, Hironori Ochi, Hidenori Toyoda, Kazuhiro Nouso, Akemi Tsutsui, Takuya Nagano, Norio ItokawaKorenobu Hayama, Michitaka Imai, Kouji Joko, Yohei Koizumi, Yoichi Hiasa

^*Corresponding author for this work

Internal Medicine （3）

Research output: Contribution to journal › Article › peer-review

45 Scopus citations

Abstract

Aim: Lenvatinib has become available as first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non-elderly patients with HCC who received lenvatinib. Methods: A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non-elderly. Results: In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar-plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related fatigue (12.0%). In the non-elderly group, >20% of patients experienced palmar-plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related proteinuria (10.0%). There were no significant differences between the elderly and non-elderly groups in the frequency of adverse events. Regarding overall and progression-free survival, there were no significant differences between the elderly and non-elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar-plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis. Conclusions: Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.

Original language	English
Pages (from-to)	75-83
Number of pages	9
Journal	Hepatology Research
Volume	50
Issue number	1
DOIs	https://doi.org/10.1111/hepr.13427
State	Published - 2020/01/01

Keywords

adverse event
elderly patient
hepatocellular carcinoma
lenvatinib
prognosis

ASJC Scopus subject areas

Hepatology
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1111/hepr.13427

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Tada, T., Kumada, T., Hiraoka, A., Michitaka, K., Atsukawa, M., Hirooka, M., Tsuji, K., Ishikawa, T., Takaguchi, K., Kariyama, K., Itobayashi, E., Tajiri, K., Shimada, N., Shibata, H., Ochi, H., Toyoda, H., Nouso, K., Tsutsui, A., Nagano, T., ... Hiasa, Y. (2020). Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching. Hepatology Research, 50(1), 75-83. https://doi.org/10.1111/hepr.13427

@article{c9a60e39bb574eb0b455e5b701933e50,

title = "Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching",

abstract = "Aim: Lenvatinib has become available as first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non-elderly patients with HCC who received lenvatinib. Methods: A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non-elderly. Results: In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar-plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related fatigue (12.0%). In the non-elderly group, >20% of patients experienced palmar-plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related proteinuria (10.0%). There were no significant differences between the elderly and non-elderly groups in the frequency of adverse events. Regarding overall and progression-free survival, there were no significant differences between the elderly and non-elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar-plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis. Conclusions: Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.",

keywords = "adverse event, elderly patient, hepatocellular carcinoma, lenvatinib, prognosis",

author = "Toshifumi Tada and Takashi Kumada and Atsushi Hiraoka and Kojiro Michitaka and Masanori Atsukawa and Masashi Hirooka and Kunihiko Tsuji and Toru Ishikawa and Koichi Takaguchi and Kazuya Kariyama and Ei Itobayashi and Kazuto Tajiri and Noritomo Shimada and Hiroshi Shibata and Hironori Ochi and Hidenori Toyoda and Kazuhiro Nouso and Akemi Tsutsui and Takuya Nagano and Norio Itokawa and Korenobu Hayama and Michitaka Imai and Kouji Joko and Yohei Koizumi and Yoichi Hiasa",

note = "Publisher Copyright: {\textcopyright} 2019 The Japan Society of Hepatology",

year = "2020",

month = jan,

day = "1",

doi = "10.1111/hepr.13427",

language = "英語",

volume = "50",

pages = "75--83",

journal = "Hepatology Research",

issn = "1386-6346",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "1",

}

Tada, T, Kumada, T, Hiraoka, A, Michitaka, K, Atsukawa, M, Hirooka, M, Tsuji, K, Ishikawa, T, Takaguchi, K, Kariyama, K, Itobayashi, E, Tajiri, K, Shimada, N, Shibata, H, Ochi, H, Toyoda, H, Nouso, K, Tsutsui, A, Nagano, T, Itokawa, N, Hayama, K, Imai, M, Joko, K, Koizumi, Y & Hiasa, Y 2020, 'Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching', Hepatology Research, vol. 50, no. 1, pp. 75-83. https://doi.org/10.1111/hepr.13427

TY - JOUR

T1 - Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma

T2 - A multicenter analysis with propensity score matching

AU - Tada, Toshifumi

AU - Kumada, Takashi

AU - Hiraoka, Atsushi

AU - Michitaka, Kojiro

AU - Atsukawa, Masanori

AU - Hirooka, Masashi

AU - Tsuji, Kunihiko

AU - Ishikawa, Toru

AU - Takaguchi, Koichi

AU - Kariyama, Kazuya

AU - Itobayashi, Ei

AU - Tajiri, Kazuto

AU - Shimada, Noritomo

AU - Shibata, Hiroshi

AU - Ochi, Hironori

AU - Toyoda, Hidenori

AU - Nouso, Kazuhiro

AU - Tsutsui, Akemi

AU - Nagano, Takuya

AU - Itokawa, Norio

AU - Hayama, Korenobu

AU - Imai, Michitaka

AU - Joko, Kouji

AU - Koizumi, Yohei

AU - Hiasa, Yoichi

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Aim: Lenvatinib has become available as first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non-elderly patients with HCC who received lenvatinib. Methods: A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non-elderly. Results: In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar-plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related fatigue (12.0%). In the non-elderly group, >20% of patients experienced palmar-plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related proteinuria (10.0%). There were no significant differences between the elderly and non-elderly groups in the frequency of adverse events. Regarding overall and progression-free survival, there were no significant differences between the elderly and non-elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar-plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis. Conclusions: Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.

AB - Aim: Lenvatinib has become available as first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non-elderly patients with HCC who received lenvatinib. Methods: A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non-elderly. Results: In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar-plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related fatigue (12.0%). In the non-elderly group, >20% of patients experienced palmar-plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment-related adverse events. In addition, >10% of patients experienced grade ≥3 treatment-related proteinuria (10.0%). There were no significant differences between the elderly and non-elderly groups in the frequency of adverse events. Regarding overall and progression-free survival, there were no significant differences between the elderly and non-elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar-plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis. Conclusions: Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.

KW - adverse event

KW - elderly patient

KW - hepatocellular carcinoma

KW - lenvatinib

KW - prognosis

UR - http://www.scopus.com/inward/record.url?scp=85076343239&partnerID=8YFLogxK

U2 - 10.1111/hepr.13427

DO - 10.1111/hepr.13427

M3 - 学術論文

C2 - 31660700

AN - SCOPUS:85076343239

SN - 1386-6346

VL - 50

SP - 75

EP - 83

JO - Hepatology Research

JF - Hepatology Research

IS - 1

ER -

Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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