Lenvatinib versus sorafenib in first‐line treatment of unresectable hepatocellular carcinoma: An inverse probability of treatment weighting analysis. (20th February 2021)

• Record Type: Journal Article
• Authors: Casadei‐Gardini, Andrea; Scartozzi, Mario; Tada, Toshifumi; Yoo, Changhoon; Shimose, Shigeo; Masi, Gianluca; Lonardi, Sara; Frassineti, Luca Giovanni; Nicola, Silvestris; Piscaglia, Fabio; Kumada, Takashi; Kim, Hyung‐Don; Koga, Hironori; Vivaldi, Caterina; Soldà, Caterina; Hiraoka, Atsushi; Bang, Yeonghak; Atsukawa, Masanori; Torimura, Takuji; Tsuj, Kunihiko; Itobayashi, Ei; Toyoda, Hidenori; Fukunishi, Shinya; Rimassa, Lorenza; Rimini, Margherita; Cascinu, Stefano; Cucchetti, Alessandro
• Other Names: Nakamura Shinichiro investigator.; Michitaka Kojiro investigator.; Itokawa Norio investigator.; Hayama Korenobu investigator.; Hirooka Masashi investigator.; Koizumi Yohei investigator.; Hiasa Yoichi investigator.; Ishikawa Toru investigator.; Imai Michitaka investigator.; Takaguchi Koichi investigator.; Tsutsui Akemi investigator.; Nagano Takuya investigator.; Kariyama Kazuya investigator.; Nouso Kazuhiro investigator.; Tajiri Kazuto investigator.; Shimada Noritomo investigator.; Shibata Hiroshi investigator.; Ochi Hironori investigator.; Joko Kouji investigator.; Yasuda Satoshi investigator.; Ohama Hideko investigator.; Kawata Kazuhito investigator.
• Is Part Of: Liver international. Volume 41:Number 6(2021)
• Page Start: 1389
• Page End: 1397
• Publication Date: 2021-02-20
• Subjects: extrahepatic disease -- lenvatinib -- performance status -- sorafenib -- survival -- trans‐arterial chemoembolization; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.14817
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Purpose: Data from common clinical practice were used to generate balanced cohorts of patients receiving either sorafenib or lenvatinib, for unresectable hepatocellular carcinoma, with the final aim to investigate their declared equivalence. Methods: Clinical features of lenvatinib and sorafenib patients were balanced through inverse probability of treatment weighting (IPTW) methodology, which weights patients' characteristics and measured outcomes of each patient in both treatment arms. Overall survival was the primary endpoint and occurrence of adverse events was the secondary. Results: The analysis included 385 patients who received lenvatinib, and 555 patients who received sorafenib. In the unadjusted cohort, lenvatinib did not show a survival advantage over sorafenib (HR: 0.85, 95% CI 0.70‐1.02). After IPTW adjustment, lenvatinib still not returned a survival advantage over sorafenib (HR: 0.82, 95% CI: 0.62‐1.07) even in presence of balanced baseline characteristics. Lenvatinib provided longer survival than sorafenib in patients previously submitted to TACE (HR: 0.69), with PS of 0 (HR: 0.73) or without extrahepatic disease (HR: 0.69). Conclusion: Present results confirmed randomized controlled trial in the real‐life setting, but also suggests that in earlier stages some benefit can be expected.