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- Title
Impact of Early Lenvatinib Administration on Survival in Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicenter, Inverse Probability Weighting Analysis.
- Authors
Tada, Toshifumi; Kumada, Takashi; Hiraoka, Atsushi; Michitaka, Kojiro; Atsukawa, Masanori; Hirooka, Masashi; Tsuji, Kunihiko; Ishikawa, Toru; Takaguchi, Koichi; Kariyama, Kazuya; Itobayashi, Ei; Tajiri, Kazuto; Shimada, Noritomo; Shibata, Hiroshi; Ochi, Hironori; Yasuda, Satoshi; Toyoda, Hidenori; Fukunishi, Shinya; Ohama, Hideko; Kawata, Kazuhito
- Abstract
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.
- Subjects
RESEARCH; SURVIVAL; CONFIDENCE intervals; MULTIVARIATE analysis; ANTINEOPLASTIC agents; MEDICAL cooperation; CHEMOEMBOLIZATION; SEVERITY of illness index; TREATMENT effectiveness; DESCRIPTIVE statistics; HEPATOCELLULAR carcinoma; EARLY medical intervention; PROPORTIONAL hazards models; PHARMACODYNAMICS
- Publication
Oncology, 2021, Vol 99, Issue 8, p518
- ISSN
0030-2414
- Publication type
Article
- DOI
10.1159/000515896