Therapeutic efficacy of lenvatinib in hepatocellular carcinoma patients with portal hypertension. Issue 9 (3rd August 2020)

• Record Type: Journal Article
• Authors: Maesaka, Kazuki; Sakamori, Ryotaro; Yamada, Ryoko; Urabe, Ayako; Tahata, Yuki; Oshita, Masahide; Ohkawa, Kazuyoshi; Mita, Eiji; Hagiwara, Hideki; Tamura, Shinji; Ito, Toshifumi; Yakushijin, Takayuki; Iio, Sadaharu; Kodama, Takahiro; Hikita, Hayato; Tatsumi, Tomohide; Takehara, Tetsuo
• Is Part Of: Hepatology research. Volume 50:Issue 9(2020)
• Page Start: 1091
• Page End: 1100
• Publication Date: 2020-08-03
• Subjects: albumin‐bilirubin grade -- hepatocellular carcinoma -- lenvatinib -- portal hypertension -- relative dose intensity; Liver -- Diseases -- Periodicals; Liver Diseases -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1111/hepr.13537
• Languages: English
• ISSNs: 1386-6346

Abstract

Abstract : Aim: Preserved liver function may be an important factor affecting therapeutic efficacy in hepatocellular carcinoma patients treated with lenvatinib, but not all patients can be treated while preserving liver function. This study evaluated the therapeutic efficacy of lenvatinib in patients with poor liver function with and without portal hypertension. Methods: This prospectively registered multicenter study analyzed 93 patients treated with lenvatinib. Progression‐free survival was compared between patients with and without advanced portal hypertension according to baseline liver function. Advanced portal hypertension was defined as having both splenomegaly and any portosystemic collaterals. Results: A total of 37 patients (40.7%) had advanced portal hypertension. Progression‐free survival did not differ between patients with and without advanced portal hypertension in the entire cohort (median 7.6 vs. 4.1 months, respectively; P = 0.148), but was significantly longer in patients with advanced portal hypertension than in those without advanced portal hypertension in the albumin‐bilirubin grade 2 or 3 group (median 7.6 vs. 2.1 months, respectively; P = 0.016). In a multivariate analysis, the presence of advanced portal hypertension was identified as the only significant predictor associated with prolonged progression‐free survival in the albumin‐bilirubin grade 2 or 3 group. Conclusions: Advanced portal hypertension was associated with the therapeutic efficacy of lenvatinib in controlling the progression of hepatocellular carcinoma in patients with poor liver function.