Therapeutic efficacy of lenvatinib for patients with unresectable hepatocellular carcinoma based on the middle-term outcome
Therapeutic efficacy of lenvatinib for patients with unresectable hepatocellular carcinoma based on the middle-term outcome
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DOI：
10.1371/journal.pone.0231427
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发表时间：
2020-04-10
期刊：
影响因子：
3.7
通讯作者：
Mochida, Satoshi
中科院分区：
文献类型：
--
作者：
Fuchigami, Akira;Imai, Yukinori;Mochida, Satoshi
Aim本研究旨在阐明乐伐替尼对不可切除肝细胞癌（HCC）患者的有效性。受试者为69例接受乐伐替尼治疗的HCC患者，中位年龄为73岁，分别有14例和67例患者既往接受过瑞戈非尼和/或索拉非尼治疗，而未接受分子靶向药物治疗。治疗效果进行了评估，使用对比增强CT图像开始后4-8周的乐伐替尼和中期的结果，使用Kaplan-Meier method.ResultsThe基线Child-Pugh评分分别为5，6和7 31，32和6例，分别和改良白蛋白胆红素（mALBI）等级分别为1，2a和2b的20，20和29例患者，分别。在先前治疗后缩小尺寸后，巴塞罗那诊所肝癌（BCLC）分期分别为17、22和30例患者的A、B和C。54例患者进行了疗效评价，CR、PR、SD和PD的患者比例分别为3.7%、44.4%、37.0%和14.8%。与基线相比，ALBI评分在治疗开始后4 - 12周显著恶化。48周时达到CR/PR的患者（95.5%）的累积生存率显著高于无反应的患者（54.3%）。多变量分析显示，BCLC阶段和血清AFP水平与治疗效果显着相关，而mALBI等级与中期outcome.ConclusionsA有利的中期结果是获得在接受乐伐替尼的HCC患者，特别是在那些表现为1/2A级mALBI在基线，尽管在治疗过程中ALBI评分恶化。
AimThis study sought to clarify the usefulness of lenvatinib for patients with unresectable hepatocellular carcinoma (HCC).MethodsThe subjects were 69 patients with HCC receiving lenvatinib; the median age was 73 years, and 14 and 67 patients had been previously treated with regorafenib and/or sorafenib and therapies without molecular-targeted agents, respectively. Therapeutic efficacy was evaluated using contrast-enhanced CT images obtained 4-8 weeks after the start of lenvatinib and the middle-term outcome using Kaplan-Meier method.ResultsThe baseline Child-Pugh scores were 5, 6 and 7 in 31, 32 and 6 patients, respectively, and the modified albumin-bilirubin (mALBI) grades were 1, 2a and 2b in 20, 20 and 29 patients, respectively. The Barcelona Clinic Liver Cancer (BCLC) stages following downsizing after prior treatment were A, B and C in 17, 22 and 30 patients, respectively. The therapeutic efficacy was evaluated in 54 patients, and the percentages of patients achieving CR, PR, SD and PD were 3.7%, 44.4%, 37.0%, and 14.8%, respectively. The ALBI scores deteriorated significantly between 4 and 12 weeks after the start of therapy, compared with the baseline. The cumulative survival rates at 48 weeks were significantly higher among patients achieving CR/PR (95.5%) than among those showing no response (54.3%). Multivariate analyses revealed that the BCLC stages and the serum AFP levels were significantly associated with therapeutic efficacy, while the mALBI grade was associated with the middle-term outcome.ConclusionsA favorable middle-term outcome was obtained in patients with HCC receiving lenvatinib, especially in those manifesting grades 1/2a mALBI at baseline, despite the deterioration in ALBI scores during treatment.