Hypothyroidism is a Predictive Factor for Better Clinical Outcomes in Patients with Advanced Hepatocellular Carcinoma Undergoing Lenvatinib Therapy.
Hypothyroidism is a Predictive Factor for Better Clinical Outcomes in Patients with Advanced Hepatocellular Carcinoma Undergoing Lenvatinib Therapy.
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DOI：
10.3390/cancers12113078
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发表时间：
2020-10-22
期刊：
影响因子：
5.2
通讯作者：
Kagawa T
中科院分区：
文献类型：
--
作者：
Shomura M;Okabe H;Sato E;Fukai K;Shiraishi K;Hirose S;Tsuruya K;Arase Y;Anzai K;Kagawa T
接受分子靶向治疗的晚期肝细胞癌（HCC）患者经常发生不可忽略的不良事件（AE）。奇怪的是，据报告某些AE与良好预后相关。我们旨在确定接受乐伐替尼治疗的HCC患者的治疗持续时间和总生存期（OS）的预测因素。本研究表明，基线肝功能较好可预测接受乐伐替尼治疗的晚期HCC患者的治疗持续时间较长和预后较好。此外，在接受乐伐替尼治疗晚期HCC的患者中，2/3级甲状腺功能减退AE与更好的预后相关。持续的抗癌治疗和适当的甲状腺激素替代可能有助于延长生存期。接受分子靶向治疗的晚期肝细胞癌（HCC）患者经常发生不可忽略的不良事件（AE）。奇怪的是，据报告某些AE与良好预后相关。我们旨在确定接受乐伐替尼治疗的HCC患者的治疗持续时间和总生存期（OS）的预测因素。对2018年4月至2019年11月期间接受乐伐替尼治疗的46例连续晚期HCC患者进行了前瞻性随访，直至2019年11月。在治疗开始后2-3个月，根据改良的实体瘤疗效评价标准评估治疗疗效。疾病控制率（DCR）定义为完全缓解、部分缓解或疾病稳定的患者百分比。DCR为65.2%，中位生存期为10.2个月。2/3级低白蛋白血症导致治疗持续时间缩短。预测OS较长的因素是基线时Child-Pugh评分为5分和发生2/3级甲状腺功能减退症。相反，2/3级低白蛋白血症与较差的预后相关。在接受乐伐替尼治疗晚期HCC的患者中，2/3级甲状腺功能减退AE与预后较好相关。持续抗癌治疗和适当的甲状腺激素替代治疗可能有助于延长OS。
Patients with advanced hepatocellular carcinoma (HCC) undergoing molecular targeted therapy often experience non-negligible adverse events (AEs). Paradoxically, certain AEs are reportedly associated with a good prognosis. We aimed to identify factors predictive of treatment duration and overall survival (OS) in patients with HCC undergoing lenvatinib therapy. This study suggested that better baseline liver function was predictive of longer treatment duration and better prognosis in patients with advanced HCC treated with lenvatinib. Moreover, an AE of Grade 2/3 hypothyroidism was associated with a better prognosis in patients receiving lenvatinib treatment for advanced HCC. Continuing anticancer therapy with appropriate thyroid hormone replacement may contribute to longer survival. Patients with advanced hepatocellular carcinoma (HCC) undergoing molecular targeted therapy often experience non-negligible adverse events (AEs). Paradoxically, certain AEs are reportedly associated with a good prognosis. We aimed to identify factors predictive of treatment duration and overall survival (OS) in patients with HCC undergoing lenvatinib therapy. Forty-six consecutive patients with advanced HCC who received lenvatinib therapy from April 2018 to November 2019 were prospectively followed until November 2019. Treatment efficacy was assessed according to the modified Response Evaluation Criteria in Solid Tumors for 2–3 months after therapy initiation. The disease control rate (DCR) was defined as the percentage of patients with a complete response, partial response, or stable disease. The DCR was 65.2%, with a median survival of 10.2 months. Grade 2/3 hypoalbuminemia resulted in shorter treatment duration. Factors predictive of longer OS were a Child-Pugh score of 5 at baseline and the occurrence of Grade 2/3 hypothyroidism. Conversely, Grade 2/3 hypoalbuminemia was associated with a poorer prognosis. An AE of Grade 2/3 hypothyroidism was associated with a better prognosis in patients receiving lenvatinib treatment for advanced HCC. Continuing anticancer therapy with appropriate thyroid hormone replacement may contribute to longer OS.
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