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Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study
The comparative efficacy and safety between lenvatinib and hepatic artery infusion chemotherapy (HAIC) in patients with unresectable hepatocellular carcinoma (HCC) is still unclear. This multicenter historical cohort study enrolled 244 patients who were treated with HAIC (n = 173) or lenvatinib (n =...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464794/ https://www.ncbi.nlm.nih.gov/pubmed/34575160 http://dx.doi.org/10.3390/jcm10184045 |
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author | Lee, Jaejun Han, Ji-Won Sung, Pil-Soo Lee, Soon-Kyu Yang, Hyun Nam, Hee-Chul Yoo, Sun-Hong Lee, Hae-Lim Kim, Hee-Yeon Lee, Sung-Won Kwon, Jung-Hyun Jang, Jeong-Won Kim, Chang-Wook Nam, Soon-Woo Oh, Jung-Suk Chun, Ho-Jong Bae, Si-Hyun Choi, Jong-Young Yoon, Seung-Kew |
author_facet | Lee, Jaejun Han, Ji-Won Sung, Pil-Soo Lee, Soon-Kyu Yang, Hyun Nam, Hee-Chul Yoo, Sun-Hong Lee, Hae-Lim Kim, Hee-Yeon Lee, Sung-Won Kwon, Jung-Hyun Jang, Jeong-Won Kim, Chang-Wook Nam, Soon-Woo Oh, Jung-Suk Chun, Ho-Jong Bae, Si-Hyun Choi, Jong-Young Yoon, Seung-Kew |
author_sort | Lee, Jaejun |
collection | PubMed |
description | The comparative efficacy and safety between lenvatinib and hepatic artery infusion chemotherapy (HAIC) in patients with unresectable hepatocellular carcinoma (HCC) is still unclear. This multicenter historical cohort study enrolled 244 patients who were treated with HAIC (n = 173) or lenvatinib (n = 71) between 2012 and 2020. Propensity score matching (PSM) was performed, and 52 patients were selected per group. Clinical outcomes and safety were compared. Objective response rate (ORR) was not different between the two groups (26.0% vs. 23.1%, p = 0.736). Before PSM, the HAIC group had a higher proportion of Child-Pugh B and portal vein tumor, whereas the lenvatinib group had more patients with extrahepatic metastases, which was adjusted after PSM. There were no differences in progression-free survival (PFS) and overall survival (OS) after PSM (HAIC vs. lenvatinib, median PFS, 3.6 vs. 4.0 months, p = 0.706; median OS 10.8 vs. 7.9 months, p = 0.106). Multivariate Cox-regression showed that alpha-fetoprotein ≤1000 ng/mL was only an associated factor for OS after PSM in all patients (hazard ratio = 0.421, p = 0.011). Subgroup analysis for patients with a high tumor burden beyond the REFLECT eligibility criteria revealed that the HAIC group (n = 29) had a significantly longer OS than did the lenvatinib group (n = 30) (10.0 vs. 5.4 months, p = 0.004). More patients in the HAIC group achieved better liver function than those in the lenvatinib group at the time of best responses. There was no difference in the incidence of grade 3 and 4 adverse events between the two groups. Therefore, lenvatinib is comparable to HAIC in terms of ORR and OS in unresectable HCC meeting REFLECT eligibility criteria. |
format | Online Article Text |
id | pubmed-8464794 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-84647942021-09-27 Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study Lee, Jaejun Han, Ji-Won Sung, Pil-Soo Lee, Soon-Kyu Yang, Hyun Nam, Hee-Chul Yoo, Sun-Hong Lee, Hae-Lim Kim, Hee-Yeon Lee, Sung-Won Kwon, Jung-Hyun Jang, Jeong-Won Kim, Chang-Wook Nam, Soon-Woo Oh, Jung-Suk Chun, Ho-Jong Bae, Si-Hyun Choi, Jong-Young Yoon, Seung-Kew J Clin Med Article The comparative efficacy and safety between lenvatinib and hepatic artery infusion chemotherapy (HAIC) in patients with unresectable hepatocellular carcinoma (HCC) is still unclear. This multicenter historical cohort study enrolled 244 patients who were treated with HAIC (n = 173) or lenvatinib (n = 71) between 2012 and 2020. Propensity score matching (PSM) was performed, and 52 patients were selected per group. Clinical outcomes and safety were compared. Objective response rate (ORR) was not different between the two groups (26.0% vs. 23.1%, p = 0.736). Before PSM, the HAIC group had a higher proportion of Child-Pugh B and portal vein tumor, whereas the lenvatinib group had more patients with extrahepatic metastases, which was adjusted after PSM. There were no differences in progression-free survival (PFS) and overall survival (OS) after PSM (HAIC vs. lenvatinib, median PFS, 3.6 vs. 4.0 months, p = 0.706; median OS 10.8 vs. 7.9 months, p = 0.106). Multivariate Cox-regression showed that alpha-fetoprotein ≤1000 ng/mL was only an associated factor for OS after PSM in all patients (hazard ratio = 0.421, p = 0.011). Subgroup analysis for patients with a high tumor burden beyond the REFLECT eligibility criteria revealed that the HAIC group (n = 29) had a significantly longer OS than did the lenvatinib group (n = 30) (10.0 vs. 5.4 months, p = 0.004). More patients in the HAIC group achieved better liver function than those in the lenvatinib group at the time of best responses. There was no difference in the incidence of grade 3 and 4 adverse events between the two groups. Therefore, lenvatinib is comparable to HAIC in terms of ORR and OS in unresectable HCC meeting REFLECT eligibility criteria. MDPI 2021-09-07 /pmc/articles/PMC8464794/ /pubmed/34575160 http://dx.doi.org/10.3390/jcm10184045 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Lee, Jaejun Han, Ji-Won Sung, Pil-Soo Lee, Soon-Kyu Yang, Hyun Nam, Hee-Chul Yoo, Sun-Hong Lee, Hae-Lim Kim, Hee-Yeon Lee, Sung-Won Kwon, Jung-Hyun Jang, Jeong-Won Kim, Chang-Wook Nam, Soon-Woo Oh, Jung-Suk Chun, Ho-Jong Bae, Si-Hyun Choi, Jong-Young Yoon, Seung-Kew Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title | Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title_full | Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title_fullStr | Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title_full_unstemmed | Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title_short | Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study |
title_sort | comparative analysis of lenvatinib and hepatic arterial infusion chemotherapy in unresectable hepatocellular carcinoma: a multi-center, propensity score study |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464794/ https://www.ncbi.nlm.nih.gov/pubmed/34575160 http://dx.doi.org/10.3390/jcm10184045 |
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