TY - JOUR
T1 - Adverse events as potential predictive factors of activity in patients with advanced hepatocellular carcinoma treated with lenvatinib
AU - Rapposelli, Ilario Giovanni
AU - Tada, Toshifumi
AU - Shimose, Shigeo
AU - Burgio, Valentina
AU - Kumada, Takashi
AU - Iwamoto, Hideki
AU - Hiraoka, Atsushi
AU - Niizeki, Takashi
AU - Atsukawa, Masanori
AU - Koga, Hironori
AU - Hirooka, Masashi
AU - Torimura, Takuji
AU - Iavarone, Massimo
AU - Tortora, Raffaella
AU - Campani, Claudia
AU - Lonardi, Sara
AU - Tamburini, Emiliano
AU - Piscaglia, Fabio
AU - Masi, Gianluca
AU - Cabibbo, Giuseppe
AU - Giuseppe Foschi, Francesco
AU - Silletta, Marianna
AU - Tsuji, Kunihiko
AU - Ishikawa, Toru
AU - Takaguchi, Koichi
AU - Kariyama, Kazuya
AU - Itobayashi, Ei
AU - Tajiri, Kazuto
AU - Shimada, Noritomo
AU - Shibata, Hiroshi
AU - Ochi, Hironori
AU - Yasuda, Satoshi
AU - Toyoda, Hidenori
AU - Fukunishi, Shinya
AU - Ohama, Hideko
AU - Kawata, Kazuhito
AU - Tani, Joji
AU - Nakamura, Shinichiro
AU - Nouso, Kazuhiro
AU - Tsutsui, Akemi
AU - Nagano, Takuya
AU - Tanaka, Takaaki
AU - Itokawa, Norio
AU - Okubo, Tomomi
AU - Arai, Taeang
AU - Imai, Michitaka
AU - Ratti, Francesca
AU - Aldrighetti, Luca
AU - Cascinu, Stefano
AU - Casadei-Gardini, Andrea
N1 - Publisher Copyright:
© 2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2021
Y1 - 2021
N2 - Background and Aim: Lenvatinib is a standard of care option in first-line therapy of advanced hepatocellular carcinoma (HCC). In the present study, we aim to identify, in patients with HCC treated with lenvatinib, a possible association between occurrence and grading of adverse events (AEs) and outcome. Methods: We performed a retrospective analysis of 606 Japanese and Italian patients treated with lenvatinib in first-line setting and investigated the possible correlation between the onset of AEs, toxicity grade (G) and outcome measures such as overall survival (OS) and progression-free survival (PFS). Results: The appearance of arterial hypertension G ≥ 2 independently predicted prolonged OS [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.46–0.93, P =.0188], whereas decreased appetite G ≥ 2 independently predicted decreased OS (HR 1.70, 95% CI 1.25–2.32, P =.0007) by multivariate analysis. Appearance of hand-foot skin reaction independently predicted prolonged PFS (HR 0.72, 95% CI 0.56–0.93, P =.0149), whereas decreased appetite G ≥ 2 predicted decreased PFS (HR 1.36, 95% CI 1.04–1.77, P =.0277). Conclusions: Our main findings are that the occurrence of arterial hypertension G ≥ 2 is a predictor of longer survival, whereas decreased appetite G ≥ 2 predicts for a poor prognosis. A careful management of AEs under lenvatinib treatment for HCC is required, to improve patients’ quality of life, minimize the need for treatment discontinuation and achieve optimal outcome.
AB - Background and Aim: Lenvatinib is a standard of care option in first-line therapy of advanced hepatocellular carcinoma (HCC). In the present study, we aim to identify, in patients with HCC treated with lenvatinib, a possible association between occurrence and grading of adverse events (AEs) and outcome. Methods: We performed a retrospective analysis of 606 Japanese and Italian patients treated with lenvatinib in first-line setting and investigated the possible correlation between the onset of AEs, toxicity grade (G) and outcome measures such as overall survival (OS) and progression-free survival (PFS). Results: The appearance of arterial hypertension G ≥ 2 independently predicted prolonged OS [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.46–0.93, P =.0188], whereas decreased appetite G ≥ 2 independently predicted decreased OS (HR 1.70, 95% CI 1.25–2.32, P =.0007) by multivariate analysis. Appearance of hand-foot skin reaction independently predicted prolonged PFS (HR 0.72, 95% CI 0.56–0.93, P =.0149), whereas decreased appetite G ≥ 2 predicted decreased PFS (HR 1.36, 95% CI 1.04–1.77, P =.0277). Conclusions: Our main findings are that the occurrence of arterial hypertension G ≥ 2 is a predictor of longer survival, whereas decreased appetite G ≥ 2 predicts for a poor prognosis. A careful management of AEs under lenvatinib treatment for HCC is required, to improve patients’ quality of life, minimize the need for treatment discontinuation and achieve optimal outcome.
KW - adverse events
KW - hepatocellular carcinoma
KW - lenvatinib
KW - predictive factors
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U2 - 10.1111/liv.15014
DO - 10.1111/liv.15014
M3 - Article
AN - SCOPUS:85110971840
VL - 41
SP - 2997
EP - 3008
JO - Liver International
JF - Liver International
SN - 1478-3223
IS - 12
ER -