Lenvatinib with or without immune checkpoint inhibitors for patients with unresectable hepatocellular carcinoma in real-world clinical practice

伦瓦提尼 医学 内科学 危险系数 肝细胞癌 不利影响 肿瘤科 索拉非尼 无容量 癌症 免疫疗法 置信区间
作者
Kang Chen,Wei Wei,Lei Liu,Zeyi Deng,Le Li,Xinmiao Liang,Pingping Guo,Lu‐Nan Qi,Zhiming Zhang,Weijuan Gong,Shan Huang,Yuan Wang,Liang Ma,Bang‐De Xiang,Le‐Qun Li,Jian‐Hong Zhong
出处
期刊:Cancer Immunology, Immunotherapy [Springer Nature]
卷期号:71 (5): 1063-1074 被引量:28
标识
DOI:10.1007/s00262-021-03060-w
摘要

Lenvatinib is regarded as the first-line therapy for patients with unresectable hepatocellular carcinoma (HCC). This study assessed the efficacy and safety of lenvatinib with or without immune checkpoint inhibitors (ICIs) in patients with unresectable HCC. In this multicentric retrospective study, patients with unresectable HCC who treated with lenvatinib with or without ICIs would be enrolled. Overall survival, progression-free survival, objective response rate, and disease control rate were calculated to assess the antitumor response. Between January 2019 and August 2020, 65 patients received lenvatinib plus ICIs while other 45 patients received lenvatinib. The baseline characteristics were comparable between the two groups. Lenvatinib plus ICIs provided significantly higher overall survival (hazard ratio = 0.47, 95% CI 0.26–0.85; p = 0.013) and progression-free survival (hazard ratio = 0.35, 95% CI 0.20–0.63; p < 0.001) than lenvatinib monotherapy. Moreover, patients with lenvatinib plus ICIs had significantly higher objective response rate (41.5% vs 20.0%, p = 0.023) and disease control rate (72.3% vs 46.7%, p = 0.009) per RECIST v1.1 than those with lenvatinib. No treatment-related deaths were observed. Grade 3 or greater adverse events occurring in 10% or more of patients in either treatment group were hypertension [13 (20.0%) of 65 patients treated with lenvatinib plus ICIs vs 8 (17.8%) of 45 patients treated with lenvatinib], and palmar–plantar erythrodysesthesia [seven (10.8%) vs two (4.4%)]. In this real-world study, lenvatinib combined with ICIs showed significantly promising efficacy and manageable safety than lenvatinib alone in patients with unresectable HCC.
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