Impact of Early Lenvatinib Administration on Survival in Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicenter, Inverse Probability Weighting Analysis
Impact of Early Lenvatinib Administration on Survival in Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicenter, Inverse Probability Weighting Analysis
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早期乐伐替尼给药对中期肝细胞癌患者生存的影响：多中心逆概率加权分析
作者：
Tada T;Kumada T;Hiraoka A;Michitaka K;Atsukawa M;Hirooka M;Tsuji K;Ishikawa T;Takaguchi K;Kariyama K;Itobayashi E;Tajiri K;Shimada N;Shibata H;Ochi H;Yasuda S;Toyoda H;Fukunishi S;Ohama H;Kawata K;Nakamura S;Nouso K;Tsutsui A;Nagano T;Hiasa Y;et al.
目的/背景：经动脉化疗栓塞术（TACE）被推荐用于中期肝细胞癌（HCC）患者。在这项研究中，我们调查了早期乐伐替尼管理中期肝癌患者的影响，特别是那些肿瘤超出了高达7 criteria.Materials/Methods：共208例中期肝癌患者的初始治疗是早期乐伐替尼管理或TACE入组。在该队列中进行多变量总生存分析。此外，使用逆概率加权（IPW）分析阐明了早期乐伐替尼给药对超过7项标准的HCC患者生存率的影响。结果：6、12、18和24个月的总累积生存率分别为94.4、79.9、65.8和50.1%。采用考克斯比例风险模型的多变量分析显示，乐伐替尼治疗HCC（风险比[HR]，0.199; 95%置信区间[CI]，0.077-0.517; p< 0.001）、甲胎蛋白≥100 ng/mL（HR，1.687）、Child-Pugh B级疾病（HR，1.825）和超过7级标准（HR，2.016）与总生存率独立相关。接受乐伐替尼治疗的患者的6、12、18和24个月累积生存率分别为96.0%、90.4%、65.7%和65.7%，接受TACE治疗的患者分别为94.1%、78.5%、65.3%和48.4%（p< 0.001）。此外，采用经IPW校正的考克斯比例风险模型进行的单变量分析显示，乐伐替尼治疗与超过7级标准的HCC患者的总生存期显著相关（HR，0.230; 95% CI，0.059-0.904;p= 0.035）。结论：乐伐替尼可能是超过7级标准的中期HCC患者的合适一线治疗。
Aim/Background:Transarterial chemoembolization (TACE) is recommended for patients with intermediate-stage hepatocellular carcinoma (HCC). In this study, we investigated the impact of early lenvatinib administration in patients with intermediate-stage HCC, especially those with tumors beyond the up-to-7 criteria.Materials/Methods:A total of 208 patients with intermediate-stage HCC whose initial treatment was early lenvatinib administration or TACE were enrolled. Multivariate overall survival analysis was performed in this cohort. In addition, the impact of early lenvatinib administration on survival in patients with HCC beyond the up-to-7 criteria was clarified using inverse probability weighting (IPW) analysis.Results:The overall cumulative survival rates at 6, 12, 18, and 24 months were 94.4, 79.9, 65.8, and 50.1%, respectively. Multivariate analysis with Cox proportional hazards modeling showed that HCC treatment with lenvatinib (hazard ratio [HR], 0.199; 95% confidence interval [CI], 0.077–0.517;p< 0.001), α-fetoprotein ≥100 ng/mL (HR, 1.687), Child-Pugh class B disease (HR, 1.825), and beyond the up-to-7 criteria (HR, 2.016) were independently associated with overall survival. The 6-, 12-, 18-, and 24-month cumulative survival rates were 96.0, 90.4, 65.7, and 65.7%, respectively, in patients treated with lenvatinib, and 94.1, 78.5, 65.3, and 48.4%, respectively, in patients who received TACE (p< 0.001). In addition, univariate analysis with Cox proportional hazards modeling adjusted by IPW showed that lenvatinib therapy was significantly associated with overall survival in patients with HCC beyond the up-to-7 criteria (HR, 0.230; 95% CI, 0.059–0.904;p= 0.035).Conclusions:Lenvatinib may be a suitable first-line treatment for patients with intermediate-stage HCC beyond the up-to-7 criteria.
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DOI：
10.1016/s0015-6264(78)80335-6
发表时间：
1986
期刊：
The New Zealand medical journal
影响因子：
--
作者：
D. Woodfield
通讯作者：
D. Woodfield
影响因子：
5.2
作者：
Kudo, Masatoshi;Ueshima, Kazuomi;Nishida, Naoshi
通讯作者：
Nishida, Naoshi
影响因子：
4.1
作者：
Tada, Toshifumi;Kumada, Takashi;Yama, Tsuyoki
通讯作者：
Yama, Tsuyoki
影响因子：
6.7
作者：
Tada, Toshifumi;Kumada, Takashi;Hiasa, Yoichi
通讯作者：
Hiasa, Yoichi
影响因子：
7
作者：
Harder, Valerie S.;Stuart, Elizabeth A.;Anthony, James C.
通讯作者：
Anthony, James C.