伦瓦提尼
医学
肝细胞癌
内科学
进行性疾病
胃肠病学
肿瘤科
疾病
索拉非尼
作者
DAISUKE NAKAGAWA,SHOHEI KOMATSU,Yoshihiko Yano,Masahiro Kido,KAORI KURAMITSU,Atsushi Yamamoto,Satoshi Omiya,YUHI SHIMURA,Tadahiro Goto,Hiroaki Yanagimoto,Hirochika Toyama,Yoshihide Ueda,Yuzo Kodama,Takumi Fukumoto
标识
DOI:10.21873/anticanres.16234
摘要
Background/Aim: The chemotherapeutic landscape for hepatocellular carcinomas (HCCs) has changed dramatically with the availability of several treatment options. This study aimed to assess the long-term outcomes of lenvatinib treatment and analyze its feasibility in the sequential treatment of HCCs. Patients and Methods: Eighty-five consecutive patients who received lenvatinib for unresectable HCCs were investigated retrospectively. Survival was assessed based on when the patients were first radiologically diagnosed with progressive disease. Among those with radiologically diagnosed stable or progressive disease at 3 months after lenvatinib administration, the cutoff α-fetoprotein (AFP) ratio (ratio of the AFP level after lenvatinib treatment to the pretreatment AFP level) that was predictive of survival was determined using receiver operating characteristic analysis. Results: The median survival time (MST) was significantly worse among patients diagnosed with progressive disease at 1 month after treatment than among those diagnosed at 2-3 or 3-4 months after treatment [MSTs at 1, 2-3, and 3-4 months: 2.2, 10.2, and 17.3 months, respectively (p<0.001)]. An AFP ratio of 1.36 (computed using the AFP level at 3 months after lenvatinib treatment) was significantly predictive of survival in patients with stable or progressive disease (26.3 vs. 11.3 months, p=0.0024). Conclusion: The prognosis of patients on lenvatinib who develop early progressive disease is dismal. Thus, their treatment should be ceased or switched. The 3-month AFP ratio of 1.36 may be a potentially useful cutoff for considering a switch to other treatments in patients radiologically diagnosed with stable or progressive disease.
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