Lenvatinib with or without Concurrent Drug-Eluting Beads Transarterial Chemoembolization in Patients with Unresectable, Advanced Hepatocellular Carcinoma: A Real-World, Multicenter, Retrospective Study

被引：39

作者：

Xia, Dongdong ^{[1
,2
,3
]}

Bai, Wei ^{[1
,2
,3
]}

Wang, Enxin ^{[1
,4
]}

Li, Jiaping ^{[5
]}

Chen, Xiaoming ^{[6
]}

Wang, Zhexuan ^{[2
,3
]}

Huang, Mingsheng ^{[7
]}

Huang, Ming ^{[8
]}

Sun, Junhui ^{[9
]}

Yang, Weizhu ^{[10
]}

Lin, Zhengyu ^{[11
]}

Wu, Jianbing ^{[12
]}

Li, Zixiang ^{[13
]}

Yang, Shufa ^{[14
]}

Zhu, Xu ^{[15
]}

Chen, Zaizhong ^{[16
]}

Zhang, Yanfang ^{[17
]}

Fan, Wenzhe ^{[5
]}

Mai, Qicong ^{[6
]}

Ding, Rong ^{[8
]}

Nie, Chunhui ^{[9
]}

Feng, Long ^{[12
]}

Li, Xueda ^{[13
]}

Huang, Wukui ^{[14
]}

Sun, Jun ^{[2
,3
]}

Wang, Qiuhe ^{[2
,3
]}

Lv, Yong ^{[2
,3
]}

Li, Xiaomei ^{[1
]}

Luo, Bohan ^{[1
]}

Wang, Zhengyu ^{[1
]}

Yuan, Jie ^{[1
]}

Guo, Wengang ^{[1
]}

Li, Kai ^{[2
,3
]}

Li, Bing ^{[1
]}

Li, Ruijun ^{[1
]}

Yin, Zhanxin ^{[1
]}

Xia, Jielai ^{[18
]}

Han, Guohong ^{[1
,2
,3
]}

机构：

[1] Northwest Univ, Digest Dis Hosp, Xian Int Med Ctr Hosp, Dept Liver Dis & Intervent Radiol, Xian, Peoples R China

[2] Fourth Mil Med Univ, Natl Clin Res Ctr Digest Dis, Dept Liver Dis & Digest Intervent Radiol, Xian, Peoples R China

[3] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Xian, Peoples R China

[4] Air Force Hosp Western Theater Command, Dept Med Affairs, Chengdu, Peoples R China

[5] Sun Yat Sen Univ, Dept Intervent Radiol, Affiliated Hosp 1, Guangzhou, Peoples R China

[6] Guangdong Prov Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Intervent Radiol, Canc Ctr, Guangzhou, Peoples R China

[7] Sun Yat Sen Univ, Affiliated Hosp 3, Dept Intervent Radiol, Guangzhou, Peoples R China

[8] Kunming Univ, Tumor Hosp Yunnan Prov, Dept Minimally Invas Int Therapy, Affiliated Hosp 3, Kunming, Yunnan, Peoples R China

[9] Zhejiang Univ, Affiliated Hosp 1, Sch Med, Dept Hepatobiliary & Pancreat Intervent Canc, Hangzhou, Peoples R China

[10] Fujian Med Univ, Dept Intervent Radiol, Union Hosp, Fuzhou, Peoples R China

[11] Fujian Med Univ, Dept Intervent Radiol, Affiliated Hosp 1, Fuzhou, Peoples R China

[12] Nanchang Univ, Dept Oncol, Affiliated Hosp 2, Nanchang, Jiangxi, Peoples R China

[13] Xinjiang Med Univ, Dept Intervent Radiol, Affiliated Tumor Hosp, Urumqi, Peoples R China

[14] Qingdao Univ, Intervent Med Ctr, Affiliated Hosp, Qingdao, Peoples R China

[15] Peking Univ, Dept Intervent Radiol, Canc Hosp, Beijing, Peoples R China

[16] Peking Univ, Dept Intervent Radiol, Shenzhen Hosp, Shenzhen, Peoples R China

[17] Shenzhen Peoples Hosp, Dept Intervent Radiol, Shenzhen, Peoples R China

[18] Fourth Mil Med Univ, Dept Hlth Stat, Xian, Peoples R China

来源：

LIVER CANCER | 2022年 / 11卷 / 04期

基金：

中国国家自然科学基金;

关键词：

Lenvatinib; Drug-eluting beads transarterial chemoembolization; Hepatocellular carcinoma; Efficacy; Safety; DOUBLE-BLIND; PORTAL-VEIN; PHASE-III; KOREAN PATIENTS; SORAFENIB; THERAPY; EFFICACY; MRECIST; SAFETY;

D O I：

10.1159/000523849

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Introduction: Lenvatinib is the first-line treatment for advanced hepatocellular carcinoma (HCC). We aimed to compare the clinical outcomes of lenvatinib plus drug-eluting beads transarterial chemoembolization (DEB-TACE) versus lenvatinib alone in real-world practice. Methods: This retrospective analysis included 142 consecutive patients who received lenvatinib plus DEB-TACE and 69 patients who received lenvatinib alone as first-line treatment from 15 Chinese academic centers from November 2018 to November 2019. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR) were evaluated by modified Response Evaluation Criteria in Solid Tumors criteria, and safety profiles were compared between the two groups. Results:The median OS and PFS were significantly longer in the combined therapy group than in the monotherapy group in whole cohort (median OS, 15.9 vs. 8.6 months, p = 0.0022; median PFS, 8.6 vs. 4.4 months, p < 0.001) and after propensity score matching analysis (median OS, 13.8 vs. 7.8 months, p = 0.03; median PFS, 7.8 vs. 4.5 months, p = 0.009). Moreover, the treatment option was an independent prognostic factor for OS and PFS with adjustment based upon baseline characteristics (adjusted hazard ratio [HR]: 0.53, 95% confidence interval [CI]: 0.36-0.78, p = 0.001, and adjusted HR: 0.42, 95% CI: 0.30-0.60, p < 0.001, respectively) and propensity score (adjusted HR: 0.52, 95% CI: 0.36-0.76, p = 0.001, and adjusted HR: 0.46, 95% CI: 0.33-0.64, p < 0.001, respectively). Moreover, a greater ORR was observed in the combined group (ORR: 46.48% vs. 13.05%, p < 0.001). Furthermore, the most common adverse events (AEs) were elevated a spartate aminotransferase (54.9%) and fatigue (46.4%) in the lenvatinib plus DEB-TACE group and lenvatinib group, respectively. Most AEs were mild-to-moderate and manageable. Conclusions: With well-tolerated safety, lenvatinib plus DEB-TACE was more effective than lenvatinib monotherapy in improving OS, PFS, and ORR. Thus, it may be a promising treatment for advanced HCC. Future prospective studies confirming these findings are warranted. (C) 2022 The Author(s). Published by S. Karger AG, Basel

引用

页码：368 / 382

页数：15

共 50 条

[1] Cabozantinib in Patients with Advanced and Progressing Hepatocellular Carcinoma [J].

Abou-Alfa, G. K. ;

Meyer, T. ;

Cheng, A. -L. ;

El-Khoueiry, A. B. ;

Rimassa, L. ;

Ryoo, B. -Y. ;

Cicin, I. ;

Merle, P. ;

Chen, Y. H. ;

Park, J. -W. ;

Blanc, J. -F. ;

Bolondi, L. ;

Klumpen, H. -J. ;

Chan, S. L. ;

Zagonel, V. ;

Pressiani, T. ;

Ryu, M. -H. ;

Venook, A. P. ;

Hessel, C. ;

Borgman-Hagey, A. E. ;

Schwab, G. ;

Kelley, R. K. .

NEW ENGLAND JOURNAL OF MEDICINE, 2018, 379 (01) :54-63

[2] Efficacy and Safety of Lenvatinib-Transcatheter Arterial Chemoembolization Sequential Therapy for Patients with Intermediate-Stage Hepatocellular Carcinoma [J].

Ando, Yuwa ;

Kawaoka, Tomokazu ;

Amioka, Kei ;

Naruto, Kensuke ;

Ogawa, Yutaro ;

Yoshikawa, Yuki ;

Kikukawa, Chihiro ;

Kosaka, Yumi ;

Uchikawa, Shinsuke ;

Morio, Kei ;

Fujino, Hatsue ;

Nakahara, Takashi ;

Murakami, Eisuke ;

Yamauchi, Masami ;

Tsuge, Masataka ;

Hiramatsu, Akira ;

Fukuhara, Takayuki ;

Mori, Nami ;

Takaki, Shintaro ;

Tsuji, Keiji ;

Nonaka, Michihiro ;

Hyogo, Hideyuki ;

Aisaka, Yasuyuki ;

Masaki, Keiichi ;

Honda, Yoji ;

Moriya, Takashi ;

Naeshiro, Noriaki ;

Takahashi, Shoichi ;

Imamura, Michio ;

Chayama, Kazuaki ;

Aikata, Hiroshi .

ONCOLOGY, 2021, 99 (08) :507-517

[3] Regorafenib for patients with hepatocellular carcinoma who progressed on sorafenib treatment (RESORCE): a randomised, double-blind, placebo-controlled, phase 3 trial [J].

Bruix, Jordi ;

Qin, Shukui ;

Merle, Philippe ;

Granito, Alessandro ;

Huang, Yi-Hsiang ;

Bodoky, Gyrogy ;

Pracht, Marc ;

Yokosuka, Osamu ;

Rosmorduc, Olivier ;

Breder, Valeriy ;

Gerolami, Rene ;

Masi, Gianluca ;

Ross, Paul J. ;

Song, Tianqiang ;

Bronowicki, Jean-Pierre ;

Ollivier-Hourmand, Isabelle ;

Kudo, Masatoshi ;

Cheng, Ann-Lii ;

Llovet, Josep M. ;

Finn, Richard S. ;

LeBerre, Marie-Aude ;

Baumhauer, Annette ;

Meinhardt, Gerold ;

Han, Guohong .

LANCET, 2017, 389 (10064) :56-66

[4] New Utility of an Old Marker: Serial α-Fetoprotein Measurement in Predicting Radiologic Response and Survival of Patients With Hepatocellular Carcinoma Undergoing Systemic Chemotherapy [J].

Chan, Stephen L. ;

Mo, Frankie K. F. ;

Johnson, Philip J. ;

Hui, Edwin P. ;

Ma, Brigette B. Y. ;

Ho, Wing M. ;

Lam, Kwok C. ;

Chan, Anthony T. C. ;

Mok, Tony S. K. ;

Yeo, Winnie .

JOURNAL OF CLINICAL ONCOLOGY, 2009, 27 (03) :446-452

[5] Efficacy and safety of sorafenib in patients in the Asia-Pacific region with advanced hepatocellular carcinoma: a phase III randomised, double-blind, placebo-controlled trial [J].

Cheng, Ann-Lii ;

Kang, Yoon-Koo ;

Chen, Zhendong ;

Tsao, Chao-Jung ;

Qin, Shukui ;

Kim, Jun Suk ;

Luo, Rongcheng ;

Feng, Jifeng ;

Ye, Shenglong ;

Yang, Tsai-Sheng ;

Xu, Jianming ;

Sun, Yan ;

Liang, Houjie ;

Liu, Jiwei ;

Wang, Jiejun ;

Tak, Won Young ;

Pan, Hongming ;

Burock, Karin ;

Zou, Jessie ;

Voliotis, Dimitris ;

Guan, Zhongzhen .

LANCET ONCOLOGY, 2009, 10 (01) :25-34

[6] Real-World Efficacy and Safety of Lenvatinib in Korean Patients with Advanced Hepatocellular Carcinoma: A Multicenter Retrospective Analysis [J].

Cheon, Jaekyung ;

Chon, Hong Jae ;

Bang, Yeonghak ;

Park, Neung Hwa ;

Shin, Jung Woo ;

Kim, Kang Mo ;

Lee, Han Chu ;

Lee, Jooho ;

Yoo, Changhoon ;

Ryoo, Baek-Yeol .

LIVER CANCER, 2020, 9 (05) :613-624

[7] Transarterial Chemoembolization Can Be Safely Performed in Patients with Hepatocellular Carcinoma Invading the Main Portal Vein and May Improve the Overall Survival [J].

Chung, Goh Eun ;

Lee, Jeong-Hoon ;

Kim, Hwi Young ;

Hwang, Sang Youn ;

Kim, Joon Suk ;

Chung, Jin Wook ;

Yoon, Jung-Hwan ;

Lee, Hyo-Suk ;

Kim, Yoon Jun .

RADIOLOGY, 2011, 258 (02) :627-634

[8] Transarterial chemoembolization plus lenvatinib versus transarterial chemoembolization plus sorafenib as first-line treatment for hepatocellular carcinoma with portal vein tumor thrombus: A prospective randomized study [J].

Ding, Xiaoyan ;

Sun, Wei ;

Li, Wei ;

Shen, Yanjun ;

Guo, Xiaodi ;

Teng, Ying ;

Liu, Xiaomin ;

Zheng, Linlin ;

Li, Wendong ;

Chen, Jinglong .

CANCER, 2021, 127 (20) :3782-3793

[9]

European Assoc Study Liver, 2018, J HEPATOL, V69, P182, DOI 10.1016/j.jhep.2018.03.019

[10] Atezolizumab plus Bevacizumab in Unresectable Hepatocellular Carcinoma [J].

Finn, Richard S. ;

Qin, Shukui ;

Ikeda, Masafumi ;

Galle, Peter R. ;

Ducreux, Michel ;

Kim, Tae-You ;

Kudo, Masatoshi ;

Breder, Valeriy ;

Merle, Philippe ;

Kaseb, Ahmed O. ;

Li, Daneng ;

Verret, Wendy ;

Xu, Derek-Zhen ;

Hernandez, Sairy ;

Liu, Juan ;

Huang, Chen ;

Mulla, Sohail ;

Wang, Yulei ;

Lim, Ho Yeong ;

Zhu, Andrew X. ;

Cheng, Ann-Lii .

NEW ENGLAND JOURNAL OF MEDICINE, 2020, 382 (20) :1894-1905

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