Comparison of the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma: a retrospective cohort study

Abstract

Background: There is lack of studies on sequential regorafenib after sorafenib and lenvatinib treatment failure in patients with unresectable hepatocellular carcinoma (HCC). This study was to explore the safety and prognosis of sequential regorafenib after sorafenib and lenvatinib failure in HCC patients.Methods: This study was a retrospective, real-world study that included 50 HCC patients who received sequential regrafinib after sorafenib and lenvatinib failure. The safety and prognosis of two groups were compared. Results:The incidence of all grade and III/IV adverse events were 68% and 24%. According to Response Evaluation Criteria in Solid Tumours (RECIST) 1.1 and modified (m) RECIST standards, the objective response rates (ORRs) after receiving regorafenib were 14.0% and 22.0%, respectively. The disease control rates (DCRs) were 62.0% and 60.0%, respectively. Based on different first-line targeted drugs, 50 patients were divided into sorafenib (n=22) and lenvatinib group (n=28). There was no differences between two groups except age and bilirubin. And there was no differences in other treatments before or after regorafenib.The baseline between two groups was basically same and had good comparability. There was no difference in incidence of all grade and III/IV adverse events, ORR and DCR between two groups (P>0.05). On long-term prognosis, total overall survival (TOS) in sorafenib and lenvatinib group were 23.0 (95% CI: 15.1-30.9) vs. 29.7 (95% CI: 21.4-38.1) months. The difference was statistically significant (P=0.041). Besides, regorafenib overall survival (ROS) in sorafenib and lenvatinib group were 11.7 (95% CI: 7.1-16.3) vs. 15.9 (95% CI: 8.3-23.5) months. The difference was statistically significant ( P=0.045). The regorafenib progression-free survival (RPFS) was 5.6 (95%

Efficacy and safety of transarterial chemoembolization combined with first-line tyrosine kinase inhibitors and programmed death-1 inhibitors for progressed hepatocellular carcinoma

“…In this work, the median OS and PFS of patients treated with TACE plus regorafenib were 9.0 and 6.0 months, which were lower than those observed in another study, which reported 11.7 months for OS and 6.7 months for PFS [29]. Greater OS and PFS have also been documented in prior studies [30,31].…”

Impact of post‐progression survival in second‐line treatment with molecular target agents for unresectable hepatocellular carcinoma

“…A search of the PubMed database identified 24 cohorts in 23 studies encompassing 2074 patients treated with REG (Figure 1 and Table ) 11,14–35 . Similarly, six cohorts from six studies comprising 621 patients treated with RAM 12,36–40 were identified, as well as seven cohorts from six studies involving 1240 patients treated with CAB 13,23,33,41–43 (Figure 1 and Tables and , respectively).…”

Regorafenib with immunotherapy versus regorafenib alone as second‐line treatment for hepatocellular carcinoma: A multicenter real‐world study

“…Previous retrospective studies also showed a difference in the survival outcomes of patients receiving regorafenib after different first‐line systemic treatments. 29 However, it should be noted that the approval of sorafenib occurred earlier than lenvatinib, resulting in differences in the initiation of actual clinical use between the two subgroups. This disparity in exposure time had an impact on the censored rates (sorafenib 52.9% vs. lenvatinib 73.1%, p < 0.003) in the second‐line treatment and consequently influenced the results.…”