BEYOND THE BORDER: THE USE OF LENVATINIB IN ADVANCED HEPATOCELLULAR CARCINOMA AFTER DIFFERENT TREATMENT LINES: A RETROSPECTIVE ANALYSIS
BEYOND THE BORDER: THE USE OF LENVATINIB IN ADVANCED HEPATOCELLULAR CARCINOMA AFTER DIFFERENT TREATMENT LINES: A RETROSPECTIVE ANALYSIS
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DOI：
10.26402/jpp.2020.5.11
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发表时间：
2020-10-01
影响因子：
2.2
通讯作者：
Siebler, J.
中科院分区：
文献类型：
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作者：
Jefremow, A.;Wiesmueller, M.;Siebler, J.
不可切除的肝细胞癌（HCC）的全身治疗在过去几年中得到了改善。不同的酪氨酸激酶抑制剂（TKI）和检查点抑制剂已被批准用于一线和二线治疗。尽管如此，关于选择正确的药物和有意义的治疗顺序的数据仍然缺失。 2017 年至 2019 年间，我们治疗了 149 名 HCC 患者。从这些患者中，我们确定了接受乐伐替尼作为一线治疗或后续治疗的患者。我们回顾性调查了七名在第二、第三或第四线治疗中接受乐伐替尼的患者的疗效和安全性。除此之外，我们将这些患者与接受乐伐替尼作为一线治疗的 13 名患者进行了治疗持续时间、总生存期 (OS)、副作用和最佳治疗反应的比较。我们发现，接受后续乐伐替尼治疗的患者中，缓解 (PR) 为 4/7，疾病稳定 (SD) 为 2/7 和 1/7，混合反应具有总体可耐受的安全性。首次和后续治疗线的治疗持续时间和总生存期相似，结果可比。每个治疗系列中的大多数副作用都是中等的。值得注意的是，在诊断为 HCC（巴塞罗那诊所肝癌 C 算法）的患者中，接受第四线乐伐替尼治疗的患者自诊断后的 OD 达到 67 个月。我们的结论是，乐伐替尼可以被视为 HCC 后续治疗方案的一种治疗选择。
The systemic treatment of unresectable hepatocellular carcinoma (HCC) has been improved throughout the past years. Different tyrosine kinase inhibitors (TKI) and checkpoint inhibitors have approval for first- and second-line treatment. Still, data are missing about the choice for the right agent and senseful therapy sequences. Between 2017 and 2019 we treated 149 HCC patients. From those, we identified the patients, who received lenvatinib either as a first-line treatment or in a later treatment line. We investigated seven patients retrospectively, who received lenvatinib in second, third, or fourth treatment line regarding efficacy and safety. Besides that, we compared those patients with 13 patients, who received lenvatinib as a first-line treatment regarding duration of therapy, overall survivial (OS), side effects and best response to treatment. We discovered remission (PR) showed 4/7, stable disease (SD) 2/7 and 1/7 mixed response with an overall tolerable safety profile in patients with a later line lenvatinib treatment. The duration and overall survival for therapy is similar in first- and later treatment lines with comparable results. Most side effects are moderate in each treatment line. Remarkably, on patient diagnoses with HCC (the Barcelona Clinic Liver Cancer C algorithm), who received lenvatinib in fourth line reached 67 months OD since diagnosis. We conclude, that lenvatinib could be considered as a treatment option of HCC for later treatment lines.