Lidia-Sabina Cosma1, Kilian Weigand2, Martina Müller-Schilling3, Arne Kandulski4. 1. Department and Outpatients Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany. . Lidia-Sabina.Cosma@ukr.de. 2. Department and Outpatients Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany. Kilian.Weigand@ukr.de. 3. Department and Outpatients Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany. Martina.Mueller-Schilling@ukr.de. 4. Department and Outpatients Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany. arne.kandulski@ukr.de.
Abstract
BACKGROUND AND AIMS: Lenvatinib is a multikinase inhibitor approved for systemic first line treatment of hepatocellular cancer (HCC) in patients with compensated liver cirrhosis (LC) and unaltered liver function. We aimed to evaluate the efficiency and tolerability of lenvatinib in patients with HCC in a real world setting, also including patients with advanced LC and impaired liver function. METHODS: Retrospectively, 35 patients with HCC BCLC stages B, C and D were screened. After drop-out and exclusion of patients not receiving active treatment for > 2 weeks, 28 patients (27 male; median age 64.7) with advanced HCC and LC were included in the analysis. RESULTS: Fourteen patients (male, median age 62.7) treated had Child-Pugh class B LC, while the other 12 patients had a good liver function Child-Pugh class A (male, median age 68.8). Two patients had advanced Child-Pugh class C LC. The patients received an escalating dosing scheme of lenvatinib up to 12 mg/d. The tolerability of lenvatinib was similar in most of the patients, with no significant difference between the subgroups. Median survival was better in patients with Child-Pugh A LC (p=0.003). More than 60% of the patients with Child-Pugh A were still on treatment at the time of data analysis with a median follow-up of 274 ± 117.5 days compared with 153 days (95%CI: 88.3 - 217.7) in patients with Child-Pugh B and 30 days in Child-Pugh C. The survival benefit correlated significantly with less impaired liver function (p=0.003). CONCLUSION: Tolerability and toxicity of lenvatinib are similar in patients withChild-Pugh class A and class B LC, but patients with less impaired liver function have a better survival benefit.
BACKGROUND AND AIMS: Lenvatinib is a multikinase inhibitor approved for systemic first line treatment of hepatocellular cancer (HCC) in patients with compensated liver cirrhosis (LC) and unaltered liver function. We aimed to evaluate the efficiency and tolerability of lenvatinib in patients with HCC in a real world setting, also including patients with advanced LC and impaired liver function. METHODS: Retrospectively, 35 patients with HCC BCLC stages B, C and D were screened. After drop-out and exclusion of patients not receiving active treatment for > 2 weeks, 28 patients (27 male; median age 64.7) with advanced HCC and LC were included in the analysis. RESULTS: Fourteen patients (male, median age 62.7) treated had Child-Pugh class B LC, while the other 12 patients had a good liver function Child-Pugh class A (male, median age 68.8). Two patients had advanced Child-Pugh class C LC. The patients received an escalating dosing scheme of lenvatinib up to 12 mg/d. The tolerability of lenvatinib was similar in most of the patients, with no significant difference between the subgroups. Median survival was better in patients with Child-Pugh A LC (p=0.003). More than 60% of the patients with Child-Pugh A were still on treatment at the time of data analysis with a median follow-up of 274 ± 117.5 days compared with 153 days (95%CI: 88.3 - 217.7) in patients with Child-Pugh B and 30 days in Child-Pugh C. The survival benefit correlated significantly with less impaired liver function (p=0.003). CONCLUSION: Tolerability and toxicity of lenvatinib are similar in patients withChild-Pugh class A and class B LC, but patients with less impaired liver function have a better survival benefit.
Authors: Sabrina Welland; Catherine Leyh; Fabian Finkelmeier; André Jefremow; Kateryna Shmanko; Maria A Gonzalez-Carmona; Arne Kandulski; Petia Jeliazkova; Jan Best; Thorben W Fründt; Angela Djanani; Maria Pangerl; Andreas Maieron; Richard Greil; Christina Fricke; Disorn Sookthai; Rainer Günther; Andreas Schmiderer; Henning Wege; Marino Venerito; Ursula Ehmer; Martina Müller; Christian P Strassburg; Arndt Weinmann; Jürgen Siebler; Oliver Waidmann; Christian M Lange; Anna Saborowski; Arndt Vogel Journal: Liver Cancer Date: 2022-01-14 Impact factor: 12.430