Details

Autor(en) / Beteiligte

• Tokunaga, Takayuki
• Tateyama, Masakuni
• Tanaka, Kentaro
• Narahara, Satoshi
• Inada, Hiroki
• Kurano, Sotaro
• Hayashi, Sanae
• Yoshimaru, Yoko
• Nagaoka, Katsuya
• Watanabe, Takehisa
• Setoyama, Hiroko
• Tanaka, Motohiko
• Tanaka, Yasuhito

Titel

Optimal management of lenvatinib therapy for patients with unresectable hepatocellular carcinoma by balancing the therapeutic effect with the relative dose intensity

Ist Teil von

• Hepatology research, 2022-01, Vol.52 (1), p.105-119

Ort / Verlag

Netherlands: Wiley Subscription Services, Inc

Erscheinungsjahr

2022

Quelle

Wiley-Blackwell Full Collection

Beschreibungen/Notizen

• Aims We aimed to assess the optimal management of first or later‐line lenvatinib therapy (LEN) for patients with unresectable hepatocellular carcinoma (uHCC), by clarifying the difference of degree between relative dose intensity (RDI) to achieve objective response (OR) and disease control (DC) by aiming at stable disease (SD), taking dose modifications into consideration. Methods One hundred uHCC patients who received LEN in first‐ or later‐line settings, between April 2018 and December 2020 in our hospital were analyzed retrospectively. The factors associated with overall survival (OS), time to progression (TTP), OR and DC were assessed. The optimal cut‐off values of RDI 4 weeks after initiation of LEN (RDI during cycle 1) and total RDI (RDI during all cycles) to predict achievement of OR and DC by aiming at SD were determined by receiver operator curve analysis. Results Achievement of OR and SD were favorable factors for OS (HR, 0.080 and 0.20) and TTP (HR, 0.052 and 0.073), with progressive disease defined as the reference. RDI ≥ 0.8 during cycle 1 and RDI ≥ 0.4 during cycle 1 contributed to achievement of OR (odds ratio, 3.28) and DC (odds ratio, 4.85), respectively. Experience of dose interruption was associated with a favorable TTP (HR, 0.58). The therapeutic line of LEN did not contribute to OS, TTP or best response. Conclusions To achieve OR and SD for a favorable outcome of first‐ or later‐line LEN, high and moderate early‐phase RDI are required, respectively. The degree of RDI during LEN and tolerance need compatible by dose modifications.