Lenvatinib plus transarterial chemoembolization with or without immune checkpoint inhibitors for unresectable hepatocellular carcinoma: A review

Sun, Liwei; Xu, Xuelong; Meng, Fanguang; Liu, Qian; Wang, Hankang; Li, Xiaodong; Li, Guijie; Chen, Feng

doi:10.3389/fonc.2022.980214

Cited by 12 publications

(8 citation statements)

References 80 publications

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“…OS and LC rates of Vp3 and Vp4 cases were also compared in cases that underwent definitive PBT. The 1-, 3-, and 5-year OS rates were 67.2% (52.0-81.9%), 45…”

Section: Analysis Based On Pvttmentioning

confidence: 92%

Proton Beam Therapy for Treating Patients with Hepatocellular Carcinoma with Major Portal Vein Tumor Invasion: A Single Center Retrospective Study

Ishida,

Mizumoto,

Saito

et al. 2024

Cancers

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Hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT) has a poor prognosis and is generally not indicated for surgery. Proton beam therapy (PBT) may offer an alternative treatment. In this study, long-term outcomes were examined in 116 patients (median age 66 years, 100 males) with HCC with advanced PVTT (Vp3 or Vp4) who received PBT from April 2008 to March 2018. Of these patients, 63 received PBT as definitive treatment and 53 as palliative treatment. The representative dose was 72.6 Gy (RBE) in 22 fractions. Eight patients died in follow-up, including 72 due to tumor progression. The 5-year overall survival (OS) rate was 18.0% (95% CI 9.8–26.2%) and the 5-year local control (LC) rate was 86.1% (74.9–97.3%). In multivariate analyses, performance status and treatment strategy were significantly associated with OS. The median follow-up period for survivors with definitive treatment was 33.5 (2–129) months, and the 5-year OS rate was 25.1% (12.9–37.3%) in these cases. The median survival time after definitive irradiation was >20 months. The 5-year OS rate was 9.1% (0–19.7%) for palliative irradiation. These results compare favorably with those of other therapies and suggest that PBT is a useful option for cases of HCC with advanced PVTT that cannot undergo surgery, with an expected survival benefit and good local control. Determining the optimal indication for this treatment is a future challenge.

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“…OS and LC rates of Vp3 and Vp4 cases were also compared in cases that underwent definitive PBT. The 1-, 3-, and 5-year OS rates were 67.2% (52.0-81.9%), 45…”

Section: Analysis Based On Pvttmentioning

confidence: 92%

Proton Beam Therapy for Treating Patients with Hepatocellular Carcinoma with Major Portal Vein Tumor Invasion: A Single Center Retrospective Study

Ishida,

Mizumoto,

Saito

et al. 2024

Cancers

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“…The inhibition of angiogenic factors by lenvatinib can improve the therapeutic effect of TACE. [45][46][47] However, there are few studies on lenvatinib combined with chemotherapy for aHCC, and more evidence is needed to prove its feasibility.…”

Section: Evidence For Multiple Treatment Methods For Hcc Patientsmentioning

confidence: 99%

Application and Resistance Mechanisms of Lenvatinib in Patients with Advanced Hepatocellular Carcinoma

Tao¹,

Shi²,

Liao³

et al. 2023

JHC

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Lenvatinib, a multitargeted tyrosine kinase inhibitor (TKI), is one of the preferred targeted drugs for the treatment of advanced hepatocellular carcinoma (aHCC). Since the REFLECT study showed that lenvatinib was noninferior to sorafenib in overall survival (OS), lenvatinib monotherapy has been widely used for aHCC. Moreover, lenvatinib combination therapy, especially lenvatinib combined with immune checkpoint inhibitors (ICIs), has shown more encouraging clinical results. However, drug development and comprehensive treatment have not significantly improved the prognosis, and lenvatinib resistance is often encountered in treatment. The underlying molecular mechanism of lenvatinib resistance is still unclear, and studies to solve drug resistance are ongoing. The molecular mechanisms of lenvatinib resistance in patients with aHCC include the regulation of signaling pathways, the regulation of noncoding RNAs, the impact of the immune microenvironment, tumor stem cell activation and other mechanisms. This review aims to (1) summarize the progress of lenvatinib in treating aHCC, (2) delineate the known lenvatinib resistance mechanisms of current therapy, and (3) describe the development of therapeutic methods intended to overcome these resistance mechanisms.

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“…Lenvatinib, a selective, multi-target drug [such as VEGFR 1-3 , FGFR 1-4 , PDGFR-α , tyrosine kinase inhibitors (TKI) of RET and KIT][ 25 ] that has gained approval from the European Drug Administration, FDA, and the National Medical Products Administration (NMPA) as a first-line treatment for advanced HCC in 2018, based on the Reflect study[ 26 ], along with lenvatinib and joining sorafenib as the standard first-line therapy. TKIs possess anti-immunosuppressive properties, wherein tumor-associated macrophages (TAM) are reduced and CD8 + T cell proliferation and activation are enhanced[ 27 , 28 ].…”

Section: Icis Combined With Tyrosine Kinase Inhibitorsmentioning

confidence: 99%

Progress in the treatment of advanced hepatocellular carcinoma with immune combination therapy

Pan,

Liu,

et al. 2024

World J Gastrointest Oncol

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Advanced hepatocellular carcinoma (HCC) is a severe malignancy that poses a serious threat to human health. Owing to challenges in early diagnosis, most patients lose the opportunity for radical treatment when diagnosed. Nonetheless, recent advancements in cancer immunotherapy provide new directions for the treatment of HCC. For instance, monoclonal antibodies against immune checkpoint inhibitors (ICIs) such as programmed cell death protein 1/death ligand-1 inhibitors and cytotoxic t-lymphocyte associated antigen-4 significantly improved the prognosis of patients with HCC. However, tumor cells can evade the immune system through various mechanisms. With the rapid development of genetic engineering and molecular biology, various new immunotherapies have been used to treat HCC, including ICIs, chimeric antigen receptor T cells, engineered cytokines, and certain cancer vaccines. This review summarizes the current status, research progress, and future directions of different immunotherapy strategies in the treatment of HCC.

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Lenvatinib plus transarterial chemoembolization with or without immune checkpoint inhibitors for unresectable hepatocellular carcinoma: A review

Cited by 12 publications

References 80 publications

Proton Beam Therapy for Treating Patients with Hepatocellular Carcinoma with Major Portal Vein Tumor Invasion: A Single Center Retrospective Study

Proton Beam Therapy for Treating Patients with Hepatocellular Carcinoma with Major Portal Vein Tumor Invasion: A Single Center Retrospective Study

Application and Resistance Mechanisms of Lenvatinib in Patients with Advanced Hepatocellular Carcinoma

Progress in the treatment of advanced hepatocellular carcinoma with immune combination therapy

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