Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma
A total of 137 HCC patients treated with atezolizumab plus bevacizumab from October 2020 to September 2022 were enrolled. The median overall survival (OS) and progression-free survival (PFS) from the beginning of atezolizumab plus bevacizumab were 21.1 months (range, 18.8 months–not reached) and 10....
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| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/22/5406 |
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| author | Shigeki Yano Tomokazu Kawaoka Shintaro Yamasaki Yusuke Johira Masanari Kosaka Yuki Shirane Ryoichi Miura Kei Amioka Kensuke Naruto Kenji Yamaoka Yasutoshi Fujii Shinsuke Uchikawa Hatsue Fujino Atsushi Ono Takashi Nakahara Eisuke Murakami Daiki Miki Masataka Tsuge Yuji Teraoka Hirotaka Kouno Shintaro Takaki Nami Mori Keiji Tsuji Shiro Oka |
| author_facet | Shigeki Yano Tomokazu Kawaoka Shintaro Yamasaki Yusuke Johira Masanari Kosaka Yuki Shirane Ryoichi Miura Kei Amioka Kensuke Naruto Kenji Yamaoka Yasutoshi Fujii Shinsuke Uchikawa Hatsue Fujino Atsushi Ono Takashi Nakahara Eisuke Murakami Daiki Miki Masataka Tsuge Yuji Teraoka Hirotaka Kouno Shintaro Takaki Nami Mori Keiji Tsuji Shiro Oka |
| author_sort | Shigeki Yano |
| collection | DOAJ |
| description | A total of 137 HCC patients treated with atezolizumab plus bevacizumab from October 2020 to September 2022 were enrolled. The median overall survival (OS) and progression-free survival (PFS) from the beginning of atezolizumab plus bevacizumab were 21.1 months (range, 18.8 months–not reached) and 10.5 months (range, 8.2–12.1 months), respectively. Fifty patients were diagnosed with progressive disease after atezolizumab plus bevacizumab. Of this group, 24 patients were administered lenvatinib, and the median OS and PFS from the beginning of lenvatinib were 15.3 months (range, 10.5 months–not reached) and 4.0 months (range, 2.5–6.4 months), respectively. The objective response rates based on the response evaluation criteria in solid tumors (RECISTs) criteria version 1.1 and modified RECISTs were 33.3% and 54.2%, respectively. There was no significant difference in the median serum alpha-fetoprotein level between before and after lenvatinib. In the multivariate analysis, Child–Pugh class A (hazard ratio 0.02, 95% confidence interval (CI) 0.02–0.76, <i>p</i> = 0.02) and intrahepatic tumor occupancy rate < 50% (hazard ratio < 0.01, 95% CI 0.003–0.35, <i>p</i> < 0.01) were the significant factors for OS. There were some frequent adverse events (AEs) in patients treated with lenvatinib such as hypertension, fatigue, anorexia, proteinuria, and so on, but none directly caused death. In conclusion, lenvatinib after atezolizumab plus bevacizumab for unresectable HCC should be considered an effective treatment option. |
| first_indexed | 2024-03-09T16:56:56Z |
| format | Article |
| id | doaj.art-aeace0015ad44ea68812d0ef7a8b225f |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T16:56:56Z |
| publishDate | 2023-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-aeace0015ad44ea68812d0ef7a8b225f2023-11-24T14:34:17ZengMDPI AGCancers2072-66942023-11-011522540610.3390/cancers15225406Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular CarcinomaShigeki Yano0Tomokazu Kawaoka1Shintaro Yamasaki2Yusuke Johira3Masanari Kosaka4Yuki Shirane5Ryoichi Miura6Kei Amioka7Kensuke Naruto8Kenji Yamaoka9Yasutoshi Fujii10Shinsuke Uchikawa11Hatsue Fujino12Atsushi Ono13Takashi Nakahara14Eisuke Murakami15Daiki Miki16Masataka Tsuge17Yuji Teraoka18Hirotaka Kouno19Shintaro Takaki20Nami Mori21Keiji Tsuji22Shiro Oka23Department of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanDepartment of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, JapanDepartment of Gastroenterology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Hiroshima 737-0023, JapanDepartment of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima 730-8619, JapanDepartment of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima 730-8619, JapanDepartment of Gastroenterology, Hiroshima Red Cross Hospital and Atomic-Bomb Survivors Hospital, Hiroshima 730-8619, JapanDepartment of Gastroenterology, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima 734-8551, JapanA total of 137 HCC patients treated with atezolizumab plus bevacizumab from October 2020 to September 2022 were enrolled. The median overall survival (OS) and progression-free survival (PFS) from the beginning of atezolizumab plus bevacizumab were 21.1 months (range, 18.8 months–not reached) and 10.5 months (range, 8.2–12.1 months), respectively. Fifty patients were diagnosed with progressive disease after atezolizumab plus bevacizumab. Of this group, 24 patients were administered lenvatinib, and the median OS and PFS from the beginning of lenvatinib were 15.3 months (range, 10.5 months–not reached) and 4.0 months (range, 2.5–6.4 months), respectively. The objective response rates based on the response evaluation criteria in solid tumors (RECISTs) criteria version 1.1 and modified RECISTs were 33.3% and 54.2%, respectively. There was no significant difference in the median serum alpha-fetoprotein level between before and after lenvatinib. In the multivariate analysis, Child–Pugh class A (hazard ratio 0.02, 95% confidence interval (CI) 0.02–0.76, <i>p</i> = 0.02) and intrahepatic tumor occupancy rate < 50% (hazard ratio < 0.01, 95% CI 0.003–0.35, <i>p</i> < 0.01) were the significant factors for OS. There were some frequent adverse events (AEs) in patients treated with lenvatinib such as hypertension, fatigue, anorexia, proteinuria, and so on, but none directly caused death. In conclusion, lenvatinib after atezolizumab plus bevacizumab for unresectable HCC should be considered an effective treatment option.https://www.mdpi.com/2072-6694/15/22/5406immune checkpoint inhibitormolecular-targeted agentfirst-line therapysecond-line therapy |
| spellingShingle | Shigeki Yano Tomokazu Kawaoka Shintaro Yamasaki Yusuke Johira Masanari Kosaka Yuki Shirane Ryoichi Miura Kei Amioka Kensuke Naruto Kenji Yamaoka Yasutoshi Fujii Shinsuke Uchikawa Hatsue Fujino Atsushi Ono Takashi Nakahara Eisuke Murakami Daiki Miki Masataka Tsuge Yuji Teraoka Hirotaka Kouno Shintaro Takaki Nami Mori Keiji Tsuji Shiro Oka Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma Cancers immune checkpoint inhibitor molecular-targeted agent first-line therapy second-line therapy |
| title | Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma |
| title_full | Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma |
| title_fullStr | Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma |
| title_full_unstemmed | Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma |
| title_short | Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma |
| title_sort | therapeutic efficacy and safety of lenvatinib after atezolizumab plus bevacizumab for unresectable hepatocellular carcinoma |
| topic | immune checkpoint inhibitor molecular-targeted agent first-line therapy second-line therapy |
| url | https://www.mdpi.com/2072-6694/15/22/5406 |
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