Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis
Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis
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DOI：
10.3390/cancers12030754
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发表时间：
2020-03-01
期刊：
影响因子：
5.2
通讯作者：
Itoh, Yoshito
中科院分区：
文献类型：
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作者：
Takahashi, Aya;Moriguchi, Michihisa;Itoh, Yoshito
我们研究了lenvatinib （LEN）治疗的肝癌患者早期肿瘤缩小（ETS）与治疗结果之间的关系。对104例患者进行回顾性分析。ETS定义为根据实体瘤反应评价标准（RECIST），第一次评估时靶病变距离基线最长直径之和的肿瘤缩小。中位总生存期（OS）未达到，而中位无进展生存期（PFS）为5.0个月。区分长期应答者（PFS >= 5.0个月）和短期应答者（PFS < 5.0个月）的受试者工作特征曲线分析显示，ETS临界值为10%。与ETS < 10%相比，ETS >= 10%与更好的PFS和OS显著相关。此外，ETS >= 10%对预后的判别能力优于基于改良的recist的客观反应。多变量分析证实ETS >= 10%是更好的OS、Child-Pugh评分为5分和大血管侵袭的独立预测因子。综上所述，ETS >= 10%与LEN治疗患者的预后密切相关。这种生物标志物可以早期评估治疗反应并指导HCC的治疗决策。
We investigated the association between early tumor shrinkage (ETS) and treatment outcome in patients with hepatocellular carcinoma treated with lenvatinib (LEN). A retrospective analysis was performed in 104 patients. ETS was defined as tumor shrinkage at the first evaluation in the sum of target lesions' longest diameters from baseline according to the Response Evaluation Criteria in Solid Tumors (RECIST). The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 5.0 months. The receiver operating characteristic curve analysis in differentiating long-term responders (PFS >= 5.0 months) from short-term responders (PFS < 5.0 months) revealed an ETS cut-off value of 10%. ETS >= 10% was significantly correlated with better PFS and OS compared with ETS < 10%. Additionally, ETS >= 10% showed a better discrimination ability on prognosis compared with modified RECIST-based objective response at the first evaluation. Multivariate analysis confirmed ETS >= 10% as an independent predictor of better OS, as well as a Child-Pugh score of 5 and macrovascular invasion. In conclusion, ETS >= 10% was strongly associated with outcome in patients treated with LEN. This biomarker could allow earlier assessment of the treatment response and guide treatment decision-making for HCC.