Therapeutic efficacy of lenvatinib for patients with unresectable hepatocellular carcinoma based on the middle-term outcome

Abstract

This study sought to clarify the usefulness of lenvatinib for patients with unresectable hepatocellular carcinoma (HCC). Methods The subjects were 69 patients with HCC receiving lenvatinib; the median age was 73 years, and 14 and 67 patients had been previously treated with regorafenib and/or sorafenib and therapies without molecular-targeted agents, respectively. Therapeutic efficacy was evaluated using contrast-enhanced CT images obtained 4-8 weeks after the start of lenvatinib and the middle-term outcome using Kaplan-Meier method. Results The baseline Child-Pugh scores were 5, 6 and 7 in 31, 32 and 6 patients, respectively, and the modified albumin-bilirubin (mALBI) grades were 1, 2a and 2b in 20, 20 and 29 patients, respectively. The Barcelona Clinic Liver Cancer (BCLC) stages following downsizing after prior treatment were A, B and C in 17, 22 and 30 patients, respectively. The therapeutic efficacy was evaluated in 54 patients, and the percentages of patients achieving CR, PR, SD and PD were 3.7%, 44.4%, 37.0%, and 14.8%, respectively. The ALBI scores deteriorated significantly between 4 and 12 weeks after the start of therapy, compared with the baseline. The cumulative survival rates at 48 weeks were significantly higher among patients achieving CR/PR (95.5%) than among those showing no response (54.3%). Multivariate analyses revealed that the BCLC stages and the serum AFP levels were significantly associated with therapeutic efficacy, while the mALBI grade was associated with the middle-term outcome.

Furosemide as a factor to deteriorate therapeutic efficacy of rifaximin in patients with decompensated cirrhosis

“…We have previously reported that hepatic encephalopathy developed in approximately 11% of patients receiving lenvatinib for unresectable HCC during an observation period of 48 weeks. 19 The therapeutic efficacy of rifaximin in patients receiving molecular targeted drugs needs to be investigated in future.…”

“…Overt hepatic encephalopathy, however, was reported to be induced by treatment for HCC, especially during treatment with molecular targeted drugs. We have previously reported that hepatic encephalopathy developed in approximately 11% of patients receiving lenvatinib for unresectable HCC during an observation period of 48 weeks 19 . The therapeutic efficacy of rifaximin in patients receiving molecular targeted drugs needs to be investigated in future.…”

Hypothyroidism Is a Predictive Factor for Better Clinical Outcomes in Patients with Advanced Hepatocellular Carcinoma Undergoing Lenvatinib Therapy

“…In addition, a sensitivity analysis was performed by altering the models. As entered variables of Models 1, 2, 3, and 4, age, hypothyroidism grade, sex, Child-Pugh score, hypoalbuminemia grade, TNM stage, and BCLC stage were selected based on previous reports on clinical importance to outcomes [ 19 , 21 , 24 , 38 , 39 ]. We consider that the number of variables that could be entered into the model was four at the maximum because of the small sample size.…”

pH-responsive delivery vehicle based on RGD-modified polydopamine-paclitaxel-loaded poly (3-hydroxybutyrate-co-3-hydroxyvalerate) nanoparticles for targeted therapy in hepatocellular carcinoma

“…This, together with the large volume of administration of chemotherapeutic agents and their unspecific mechanism of action, causes severe side effects [ 15 ]. Therefore, the novel chemotherapeutic agents or strategies are urgently needed to treat HCC patients with minimal or tolerable side effects [ 16 ].…”

“…More recently, the use of biodegradable nanomaterials has received impressive attention. Ploy (3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), a biodegradable biopolymer with a low glass transition temperature and a hard texture, which is produced by using starch as raw material and fermentation engineering technology [ 16 , 17 ]. PHBV has a variety of advantages such as favorable biocompatibility and low manufacturing cost.…”