Evolution of Survival Impact of Molecular Target Agents in Patients with Advanced Hepatocellular Carcinoma

被引:34
作者
Kobayashi, Kazufumi [1 ,2 ]
Ogasawara, Sadahisa [1 ,2 ]
Takahashi, Aya [3 ]
Seko, Yuya [3 ]
Unozawa, Hidemi [1 ]
Sato, Rui [4 ]
Watanabe, Shunji [5 ]
Moriguchi, Michihisa [3 ]
Morimoto, Naoki [5 ]
Tsuchiya, Satoshi [4 ]
Iwai, Kenji [4 ]
Inoue, Masanori [6 ]
Ogawa, Keita [1 ]
Ishino, Takamasa [1 ]
Iwanaga, Terunao [1 ]
Sakuma, Takafumi [1 ]
Fujita, Naoto [1 ]
Kanzaki, Hiroaki [1 ]
Koroki, Keisuke [1 ]
Nakamura, Masato [1 ]
Kanogawa, Naoya [1 ]
Kiyono, Soichiro [1 ]
Kondo, Takayuki [1 ]
Saito, Tomoko [1 ]
Nakagawa, Ryo [1 ]
Suzuki, Eiichiro [1 ]
Ooka, Yoshihiko [1 ]
Nakamoto, Shingo [1 ]
Tawada, Akinobu [1 ,7 ]
Chiba, Tetsuhiro [1 ]
Arai, Makoto [1 ,7 ]
Kanda, Tatsuo [1 ,8 ]
Maruyama, Hitoshi [1 ,9 ]
Nagashima, Kengo [10 ,11 ]
Kato, Jun [1 ]
Isoda, Norio [5 ]
Aramaki, Takeshi [4 ]
Itoh, Yoshito [3 ]
Kato, Naoya [1 ]
机构
[1] Chiba Univ, Grad Sch Med, Dept Gastroenterol, Chiba, Japan
[2] Chiba Univ Hosp, Translat Res & Dev Ctr, Chiba, Japan
[3] Kyoto Prefectural Univ Med, Dept Gastroenterol & Hepatol, Kyoto, Japan
[4] Shizuoka Canc Ctr, Div Intervent Radiol, Shizuoka, Japan
[5] Jichi Med Univ, Dept Med, Div Gastroenterol, Shimotsuke, Tochigi, Japan
[6] Numazu City Hosp, Shizuoka, Japan
[7] Chiba Univ, Grad Sch Med, Dept Med Oncol, Chiba, Japan
[8] Nihon Univ, Sch Med, Dept Med, Div Gastroenterol & Hepatol, Tokyo, Japan
[9] Juntendo Univ, Sch Med, Dept Gastroenterol, Tokyo, Japan
[10] Inst Stat Math, Res Ctr Med & Hlth Data Sci, Tokyo, Japan
[11] Keio Univ Hosp, Biostat Unit, Clin & Translat Res Ctr, Tokyo, Japan
基金
日本学术振兴会;
关键词
Sequential therapy; Sorafenib; Regorafenib; Lenvatinib; Ramucirumab; PHASE-III; DOUBLE-BLIND; SORAFENIB; THERAPY; LENVATINIB; CHEMOEMBOLIZATION; REGORAFENIB; MULTICENTER; PROGRESSION; EFFICACY;
D O I
10.1159/000519868
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background and Aims: The prognosis of patients with advanced hepatocellular carcinoma (HCC) is expected to improve as multiple molecular target agents (MTAs) are now available. However, the impact of the availability of sequential MTAs has not been fully verified yet. Approach and Results: We retrospectively collected the data on the whole clinical course of 877 patients who received any MTAs as first-line systemic therapy for advanced HCC between June 2009 and March 2019. The study population was divided into 3 groups according to the date of first-line MTA administration (period 1: 2009-2012, n = 267; period 2: 2013-2016, n = 352; period 3: 2017-2019, n = 258). Then, we compared the number of MTAs used, overall survival (OS), and MTA treatment duration among the 3 groups. Analysis was also performed separately for advanced-stage and nonadvanced-stage HCC. The proportion of patients who received multiple MTAs was remarkably increased over time (1.1%, 10.2%, and 42.6% in periods 1, 2, and 3, respectively, p < 0.001). The median OS times were prolonged to 10.4, 11.3, and 15.2 months in periods 1, 2, and 3, respectively (p = 0.016). Similarly, the MTA treatment durations were extended (2.7, 3.2, and 6.6 months in periods 1, 2, and 3, respectively; p < 0.001). We confirmed that the correlation between OS and MTA treatment duration was strengthened (period 1: 0.395, period 2: 0.505, and period 3: 0.667). All these trends were pronounced in the patients with advanced-stage HCC but limited in the patients with nonadvanced-stage HCC. Conclusions: The availability of multiple MTAs had steadily improved the prognosis of patients with advanced HCC patients, particularly advanced-stage HCC patients.
引用
收藏
页码:48 / 60
页数:13
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