Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis
We investigated the association between early tumor shrinkage (ETS) and treatment outcome in patients with hepatocellular carcinoma treated with lenvatinib (LEN). A retrospective analysis was performed in 104 patients. ETS was defined as tumor shrinkage at the first evaluation in the sum of target l...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-03-01
|
| Series: | Cancers |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6694/12/3/754 |
| _version_ | 1797711341845217280 |
|---|---|
| author | Aya Takahashi Michihisa Moriguchi Yuya Seko Toshihide Shima Yasuhide Mitsumoto Hidetaka Takashima Hiroyuki Kimura Hideki Fujii Hiroki Ishikawa Takaharu Yo Hiroshi Ishiba Atsuhiro Morita Masayasu Jo Yasuyuki Nagao Masahiro Arai Tasuku Hara Akira Okajima Akira Muramatsu Naomi Yoshinami Tomoki Nakajima Hironori Mitsuyoshi Atsushi Umemura Taichiro Nishikawa Kanji Yamaguchi Takeshi Okanoue Yoshito Itoh |
| author_facet | Aya Takahashi Michihisa Moriguchi Yuya Seko Toshihide Shima Yasuhide Mitsumoto Hidetaka Takashima Hiroyuki Kimura Hideki Fujii Hiroki Ishikawa Takaharu Yo Hiroshi Ishiba Atsuhiro Morita Masayasu Jo Yasuyuki Nagao Masahiro Arai Tasuku Hara Akira Okajima Akira Muramatsu Naomi Yoshinami Tomoki Nakajima Hironori Mitsuyoshi Atsushi Umemura Taichiro Nishikawa Kanji Yamaguchi Takeshi Okanoue Yoshito Itoh |
| author_sort | Aya Takahashi |
| collection | DOAJ |
| description | We investigated the association between early tumor shrinkage (ETS) and treatment outcome in patients with hepatocellular carcinoma treated with lenvatinib (LEN). A retrospective analysis was performed in 104 patients. ETS was defined as tumor shrinkage at the first evaluation in the sum of target lesions’ longest diameters from baseline according to the Response Evaluation Criteria in Solid Tumors (RECIST). The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 5.0 months. The receiver operating characteristic curve analysis in differentiating long-term responders (PFS ≥ 5.0 months) from short-term responders (PFS < 5.0 months) revealed an ETS cut-off value of 10%. ETS ≥ 10% was significantly correlated with better PFS and OS compared with ETS < 10%. Additionally, ETS ≥ 10% showed a better discrimination ability on prognosis compared with modified RECIST-based objective response at the first evaluation. Multivariate analysis confirmed ETS ≥ 10% as an independent predictor of better OS, as well as a Child−Pugh score of 5 and macrovascular invasion. In conclusion, ETS ≥ 10% was strongly associated with outcome in patients treated with LEN. This biomarker could allow earlier assessment of the treatment response and guide treatment decision-making for HCC. |
| first_indexed | 2024-03-12T07:05:41Z |
| format | Article |
| id | doaj.art-ea6fa20494194994b08b058f8d1c5545 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T07:05:41Z |
| publishDate | 2020-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-ea6fa20494194994b08b058f8d1c55452023-09-02T23:27:51ZengMDPI AGCancers2072-66942020-03-0112375410.3390/cancers12030754cancers12030754Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter AnalysisAya Takahashi0Michihisa Moriguchi1Yuya Seko2Toshihide Shima3Yasuhide Mitsumoto4Hidetaka Takashima5Hiroyuki Kimura6Hideki Fujii7Hiroki Ishikawa8Takaharu Yo9Hiroshi Ishiba10Atsuhiro Morita11Masayasu Jo12Yasuyuki Nagao13Masahiro Arai14Tasuku Hara15Akira Okajima16Akira Muramatsu17Naomi Yoshinami18Tomoki Nakajima19Hironori Mitsuyoshi20Atsushi Umemura21Taichiro Nishikawa22Kanji Yamaguchi23Takeshi Okanoue24Yoshito Itoh25Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita 564-0013, JapanDepartment of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita 564-0013, JapanDepartment of Gastroenterology, Osaka General Hospital of West Japan Railway Company, Osaka 545-0053, JapanDepartment of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, JapanDepartment of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, JapanDepartment of Gastroenterology and Hepatology, Omihachiman Community Medical Center, Omihachiman 523-0082, JapanDepartment of Gastroenterology and Hepatology, Omihachiman Community Medical Center, Omihachiman 523-0082, JapanDepartment of Gastroenterology and Hepatology, North Medical Center of Kyoto Prefectural University of Medicine, Yosagun 629-2261, JapanDepartment of Gastroenterology, Japanese Red Cross Kyoto Daini Hospital, Kyoto 602-8026, JapanDepartment of Gastroenterology, Otsu City Hospital, Otsu 520-0804, JapanDepartment of Gastroenterology, Matsushita Memorial Hospital, Moriguchi 570-8540, JapanDepartment of Gastroenterology, Kyoto Yamashiro General Medical Center, Kizugawa 619-0214, JapanDepartment of Gastroenterology, Fukuchiyama City Hospital, Fukuchiyama 620-8505, JapanDepartment of Gastroenterology, Koseikai Takeda Hospital, Kyoto 600-8558, JapanDepartment of Gastroenterology, Akashi City Hospital, Akashi 673-8501, JapanDepartment of Gastroenterology, Kyoto City Hospital, Kyoto 604-8845, JapanDepartment of Gastroenterology, Saiseikai Kyoto Hospital, Kyoto 617-0814, JapanDepartment of Gastroenterology and Hepatology, Kyoto Chubu Medical Center, Kyoto 629-0197, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Gastroenterology and Hepatology, Saiseikai Suita Hospital, Suita 564-0013, JapanDepartment of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanWe investigated the association between early tumor shrinkage (ETS) and treatment outcome in patients with hepatocellular carcinoma treated with lenvatinib (LEN). A retrospective analysis was performed in 104 patients. ETS was defined as tumor shrinkage at the first evaluation in the sum of target lesions’ longest diameters from baseline according to the Response Evaluation Criteria in Solid Tumors (RECIST). The median overall survival (OS) was not reached, whereas the median progression-free survival (PFS) was 5.0 months. The receiver operating characteristic curve analysis in differentiating long-term responders (PFS ≥ 5.0 months) from short-term responders (PFS < 5.0 months) revealed an ETS cut-off value of 10%. ETS ≥ 10% was significantly correlated with better PFS and OS compared with ETS < 10%. Additionally, ETS ≥ 10% showed a better discrimination ability on prognosis compared with modified RECIST-based objective response at the first evaluation. Multivariate analysis confirmed ETS ≥ 10% as an independent predictor of better OS, as well as a Child−Pugh score of 5 and macrovascular invasion. In conclusion, ETS ≥ 10% was strongly associated with outcome in patients treated with LEN. This biomarker could allow earlier assessment of the treatment response and guide treatment decision-making for HCC.https://www.mdpi.com/2072-6694/12/3/754hepatocellular carcinomalenvatinibearly tumor shrinkageoverall survivalresponse evaluation criteria in solid tumors (recist) |
| spellingShingle | Aya Takahashi Michihisa Moriguchi Yuya Seko Toshihide Shima Yasuhide Mitsumoto Hidetaka Takashima Hiroyuki Kimura Hideki Fujii Hiroki Ishikawa Takaharu Yo Hiroshi Ishiba Atsuhiro Morita Masayasu Jo Yasuyuki Nagao Masahiro Arai Tasuku Hara Akira Okajima Akira Muramatsu Naomi Yoshinami Tomoki Nakajima Hironori Mitsuyoshi Atsushi Umemura Taichiro Nishikawa Kanji Yamaguchi Takeshi Okanoue Yoshito Itoh Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis Cancers hepatocellular carcinoma lenvatinib early tumor shrinkage overall survival response evaluation criteria in solid tumors (recist) |
| title | Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis |
| title_full | Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis |
| title_fullStr | Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis |
| title_full_unstemmed | Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis |
| title_short | Early Tumor Shrinkage as a Predictive Factor for Outcomes in Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Analysis |
| title_sort | early tumor shrinkage as a predictive factor for outcomes in hepatocellular carcinoma patients treated with lenvatinib a multicenter analysis |
| topic | hepatocellular carcinoma lenvatinib early tumor shrinkage overall survival response evaluation criteria in solid tumors (recist) |
| url | https://www.mdpi.com/2072-6694/12/3/754 |
| work_keys_str_mv | AT ayatakahashi earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT michihisamoriguchi earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT yuyaseko earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT toshihideshima earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT yasuhidemitsumoto earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hidetakatakashima earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hiroyukikimura earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hidekifujii earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hirokiishikawa earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT takaharuyo earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hiroshiishiba earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT atsuhiromorita earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT masayasujo earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT yasuyukinagao earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT masahiroarai earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT tasukuhara earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT akiraokajima earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT akiramuramatsu earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT naomiyoshinami earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT tomokinakajima earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT hironorimitsuyoshi earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT atsushiumemura earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT taichironishikawa earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT kanjiyamaguchi earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT takeshiokanoue earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis AT yoshitoitoh earlytumorshrinkageasapredictivefactorforoutcomesinhepatocellularcarcinomapatientstreatedwithlenvatinibamulticenteranalysis |