乐伐替尼治疗肝细胞癌——一项真实世界的多中心澳大利亚

StephenW

乐伐替尼治疗肝细胞癌——一项真实世界的多中心澳大利亚队列研究

    库尔维·帕特瓦拉大卫·斯蒂芬·普林斯耶尔·塞勒马杰尔瓦菲卡·阿拉姆埃尔德霍·保罗西蒙娜·艾琳·斯特拉瑟杰弗里·威廉·麦考恩保罗·高悉达斯·苏德埃莉斯·墨菲斯图尔特·罗伯茨艾略特·弗里曼伊丽莎白·斯特拉顿斯科特·安东尼·戴维森米里亚姆·塔尼亚·利维McCawley Clark-Dickson、Vi Nguyen、Sally Bell、Amanda Nicoll、Ashley Bloom、Alice Unah Lee、Marno Ryan、Jessica Howell、Zina Valaydon、Alexandra Mack、Ken Liu 和 Anouk Dev

Hepatology International 第 16 卷，第 1170–1178 页（2022 年）引用这篇文章

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抽象的
介绍

肝细胞癌（HCC）是慢性肝病的严重并发症。 Lenvatinib 是一种口服多激酶抑制剂，已注册用于治疗晚期 HCC。本研究评估了在澳大利亚使用乐伐替尼的实际经验。
方法

我们对 2018 年 7 月至 2020 年 11 月期间在澳大利亚 11 家三级医院接受乐伐替尼治疗的晚期 HCC 患者进行了一项回顾性队列研究。收集基线人口统计学数据、肿瘤特征、乐伐替尼剂量、不良事件 (AE) 和临床结果。总生存期（OS）是主要结果。无进展生存期 (PFS) 和 AE 是次要结局。
结果

共纳入 155 名患者，主要为男性（90.7%），中位年龄为 65 岁（四分位距 [IQR]：59-75）。慢性肝病的主要原因是丙型肝炎感染（40.0%）和酒精相关肝病（34.2）。中位 OS 和 PFS 分别为 7.7（95% 置信区间 [CI]：5.8-14.0）和 5.3 个月（95% CI：2.8-9.2）。死亡率的多变量预测因素是由于 AE（风险比 [HR] 0.41，p < 0.01）、新发或恶化的高血压（HR 0.42，p < 0.01）、腹泻（HR 0.47，p = 0.04）等需要减少剂量晚期 BCLC 阶段（HR 2.50，p = 0.04）。疾病进展的多变量预测因子是较高的 Child-Pugh 评分（HR 1.25，p = 0.04）、需要减少剂量（HR 0.45，p < 0.01）和年龄（HR 0.96，p < 0.001）。 83.9% 的患者发生 AE，大多数为轻度 (71.6%)。
结论

Lenvatinib 在实际使用中仍然安全有效。治疗紧急腹泻和高血压，以及需要减少剂量似乎可以预测更好的 OS。

StephenW

Lenvatinib for the treatment of hepatocellular carcinoma—a real-world multicenter Australian cohort study

    Kurvi Patwala, David Stephen Prince, Yael Celermajer, Waafiqa Alam, Eldho Paul, Simone Irene Strasser, Geoffrey William McCaughan, Paul Gow, Siddharth Sood, Elise Murphy, Stuart Roberts, Elliot Freeman, Elizabeth Stratton, Scott Anthony Davison, Miriam Tania Levy, McCawley Clark-Dickson, Vi Nguyen, Sally Bell, Amanda Nicoll, Ashley Bloom, Alice Unah Lee, Marno Ryan, Jessica Howell, Zina Valaydon, Alexandra Mack, Ken Liu & Anouk Dev

Hepatology International volume 16, pages 1170–1178 (2022)Cite this article

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Abstract
Introduction

Hepatocellular carcinoma (HCC) is a serious complication of chronic liver disease. Lenvatinib is an oral multikinase inhibitor registered to treat advanced HCC. This study evaluates the real-world experience with lenvatinib in Australia.
Methods

We conducted a retrospective cohort study of patients treated with lenvatinib for advanced HCC between July 2018 and November 2020 at 11 Australian tertiary care hospitals. Baseline demographic data, tumor characteristics, lenvatinib dosing, adverse events (AEs) and clinical outcomes were collected. Overall survival (OS) was the primary outcome. Progression free survival (PFS) and AEs were secondary outcomes.
Results

A total of 155 patients were included and were predominantly male (90.7%) with a median age of 65 years (interquartile range [IQR]: 59–75). The main causes of chronic liver disease were hepatitis C infection (40.0%) and alcohol-related liver disease (34.2). Median OS and PFS were 7.7 (95% confidence interval [CI]: 5.8–14.0) and 5.3 months (95% CI: 2.8–9.2) respectively. Multivariate predictors of mortality were the need for dose reduction due to AEs (Hazard ratio [HR] 0.41, p < 0.01), new or worsening hypertension (HR 0.42, p < 0.01), diarrhoea (HR 0.47, p = 0.04) and more advanced BCLC stage (HR 2.50, p = 0.04). Multivariable predictors of disease progression were higher Child–Pugh score (HR 1.25, p = 0.04), the need for a dose reduction (HR 0.45, p < 0.01) and age (HR 0.96, p < 0.001). AEs occurred in 83.9% of patients with most being mild (71.6%).
Conclusions

Lenvatinib remains safe and effective in real-world use. Treatment emergent diarrhoea and hypertension, and the need for dose reduction appear to predict better OS.

StephenW

https://link.springer.com/conten ... 072-022-10398-5.pdf