Impact of Early Lenvatinib Administration on Survival in Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicenter, Inverse Probability Weighting Analysis

被引：9

作者：

Tada, Toshifumi ^{[1
]}

Kumada, Takashi ^{[2
]}

Hiraoka, Atsushi ^{[3
]}

Michitaka, Kojiro ^{[3
]}

Atsukawa, Masanori ^{[4
]}

Hirooka, Masashi ^{[5
]}

Tsuji, Kunihiko ^{[6
]}

Ishikawa, Toru ^{[7
]}

Takaguchi, Koichi ^{[8
]}

Kariyama, Kazuya ^{[9
]}

Itobayashi, Ei ^{[10
]}

Tajiri, Kazuto ^{[11
]}

Shimada, Noritomo ^{[12
]}

Shibata, Hiroshi ^{[13
]}

Ochi, Hironori ^{[14
]}

Yasuda, Satoshi ^{[15
]}

Toyoda, Hidenori ^{[15
]}

Fukunishi, Shinya ^{[16
]}

Ohama, Hideko ^{[16
]}

Kawata, Kazuhito ^{[17
]}

Nakamura, Shinichiro ^{[1
]}

Nouso, Kazuhiro ^{[9
]}

Tsutsui, Akemi ^{[8
]}

Nagano, Takuya ^{[8
]}

Itokawa, Norio ^{[4
]}

Okubo, Tomomi ^{[4
]}

Arai, Taeang ^{[4
]}

Imai, Michitaka ^{[7
]}

Joko, Kouji ^{[14
]}

Koizumi, Yohei ^{[5
]}

Hiasa, Yoichi ^{[5
]}

机构：

[1] Japanese Red Cross Himeji Hosp, Dept Internal Med, Himeji, Hyogo, Japan

[2] Gifu Kyoritsu Univ, Fac Nursing, Ogaki, Japan

[3] Ehime Prefectural Cent Hosp, Gastroenterol Ctr, Matsuyama, Ehime, Japan

[4] Nippon Med Sch, Dept Internal Med, Div Gastroenterol & Hepatol, Tokyo, Japan

[5] Ehime Univ, Grad Sch Med, Dept Gastroenterol & Metabol, Matsuyama, Ehime, Japan

[6] Teine Keijinkai Hosp, Ctr Gastroenterol, Sapporo, Hokkaido, Japan

[7] Saiseikai Niigata Hosp, Dept Gastroenterol, Niigata, Japan

[8] Kagawa Prefectural Cent Hosp, Dept Hepatol, Takamatsu, Kagawa, Japan

[9] Okayama City Hosp, Dept Gastroenterol, Okayama, Japan

[10] Asahi Gen Hosp, Dept Gastroenterol, Asahi, Japan

[11] Toyama Univ Hosp, Dept Gastroenterol, Toyama, Japan

[12] Otakanomori Hosp, Div Gastroenterol & Hepatol, Kashiwa, Chiba, Japan

[13] Tokushima Prefectural Cent Hosp, Dept Gastroenterol, Tokushima, Japan

[14] Red Cross Hosp, Hepatobiliary Ctr, Matsuyama, Ehime, Japan

[15] Ogaki Municipal Hosp, Dept Gastroenterol & Hepatol, Ogaki, Japan

[16] Osaka Med Coll, Dept Internal Med 2, Takatsuki, Osaka, Japan

[17] Hamamatsu Univ Sch Med, Dept Internal Med, Hepatol Div, Hamamatsu, Shizuoka, Japan

来源：

ONCOLOGY | 2021年 / 99卷 / 08期

关键词：

Lenvatinib; Transarterial chemoembolization; Hepatocellular carcinoma; Intermediate-stage; Up-to-7; criteria; SORAFENIB;

D O I：

10.1159/000515896

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Aim/Background: Transarterial chemoembolization (TACE) is recommended for patients with intermediate-stage hepatocellular carcinoma (HCC). In this study, we investigated the impact of early lenvatinib administration in patients with intermediate-stage HCC, especially those with tumors beyond the up-to-7 criteria. Materials/Methods: A total of 208 patients with intermediate-stage HCC whose initial treatment was early lenvatinib administration or TACE were enrolled. Multivariate overall survival analysis was performed in this cohort. In addition, the impact of early lenvatinib administration on survival in patients with HCC beyond the up-to-7 criteria was clarified using inverse probability weighting (IPW) analysis. Results: The overall cumulative survival rates at 6, 12, 18, and 24 months were 94.4, 79.9, 65.8, and 50.1%, respectively. Multivariate analysis with Cox proportional hazards modeling showed that HCC treatment with lenvatinib (hazard ratio [HR], 0.199; 95% confidence interval [CI], 0.077-0.517; p < 0.001), alpha-fetoprotein >= 100 ng/mL (HR, 1.687), Child-Pugh class B disease (HR, 1.825), and beyond the up-to-7 criteria (HR, 2.016) were independently associated with overall survival. The 6-, 12-, 18-, and 24-month cumulative survival rates were 96.0, 90.4, 65.7, and 65.7%, respectively, in patients treated with lenvatinib, and 94.1, 78.5, 65.3, and 48.4%, respectively, in patients who received TACE (p < 0.001). In addition, univariate analysis with Cox proportional hazards modeling adjusted by IPW showed that lenvatinib therapy was significantly associated with overall survival in patients with HCC beyond the up-to-7 criteria (HR, 0.230; 95% CI, 0.059-0.904; p = 0.035). Conclusions: Lenvatinib may be a suitable first-line treatment for patients with intermediate-stage HCC beyond the up-to-7 criteria.

引用

页码：518 / 527

页数：10

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