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

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