Yoshinosuke Shimamura1, Koki Abe2, Takuto Maeda2, Takeshi Matsui3, Atsushi Ishiguro4, Hideki Takizawa2. 1. Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan; shimamura-yo@keijinkai.or.jp. 2. Department of Nephrology, Teine Keijinkai Medical Center, Sapporo, Japan. 3. Center for Gastroenterology, Teine Keijinkai Medical Center, Sapporo, Japan. 4. Department of Medical Oncology, Teine Keijinkai Medical Center, Sapporo, Japan.
Abstract
BACKGROUND/AIM: Lenvatinib, a multitargeted tyrosine kinase inhibitor, was recently approved for hepatocellular carcinoma (HCC) treatment in Japan; however, the association between proteinuria following lenvatinib administration in HCC patients and early mortality is unknown. This study aimed to examine the association between nephrotic-range proteinuria (NRP) and mortality and evaluated the risk factors for NRP among Japanese HCC patients treated with lenvatinib. PATIENTS AND METHODS: We retrospectively analyzed 45 consecutive patients receiving lenvatinib from 2018-2019. Primary outcome was overall survival. Cox proportional hazards regression was used to evaluate the association between NRP and overall survival. Logistic regression analyses were used to identify NRP risk factors after lenvatinib initiation. RESULTS: The median age was 66 years, 56% were women, and 20% had pre-existing proteinuria. During a 1-year median follow-up, 24 died, and 5 developed NRP. Univariable logistic regression showed that pre-existing proteinuria was associated with higher NRP risk; however, the association was not significant after covariate adjustment. Following multivariable Cox analysis, NRP did not affect overall survival in advanced HCC patients receiving lenvatinib. CONCLUSION: Urinalysis findings should be monitored regularly in patients receiving lenvatinib because NRP incidence was comparable to that of prior studies. Identifying the predictors of NRP after lenvatinib initiation warrants further investigation. Copyright
BACKGROUND/AIM: Lenvatinib, a multitargeted tyrosine kinase inhibitor, was recently approved for hepatocellular carcinoma (HCC) treatment in Japan; however, the association between proteinuria following lenvatinib administration in HCC patients and early mortality is unknown. This study aimed to examine the association between nephrotic-range proteinuria (NRP) and mortality and evaluated the risk factors for NRP among Japanese HCC patients treated with lenvatinib. PATIENTS AND METHODS: We retrospectively analyzed 45 consecutive patients receiving lenvatinib from 2018-2019. Primary outcome was overall survival. Cox proportional hazards regression was used to evaluate the association between NRP and overall survival. Logistic regression analyses were used to identify NRP risk factors after lenvatinib initiation. RESULTS: The median age was 66 years, 56% were women, and 20% had pre-existing proteinuria. During a 1-year median follow-up, 24 died, and 5 developed NRP. Univariable logistic regression showed that pre-existing proteinuria was associated with higher NRP risk; however, the association was not significant after covariate adjustment. Following multivariable Cox analysis, NRP did not affect overall survival in advanced HCC patients receiving lenvatinib. CONCLUSION: Urinalysis findings should be monitored regularly in patients receiving lenvatinib because NRP incidence was comparable to that of prior studies. Identifying the predictors of NRP after lenvatinib initiation warrants further investigation. Copyright
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