Lenvatinib With or Without Immune Checkpoint Inhibitors in Subsets of Advanced Hepatocellular Carcinoma

¹ Department of Hepatobiliary Surgery, Guangxi Liver Cancer Diagnosis and Treatment Engineering and Technology Research Center, Guangxi Medical University Cancer Hospital, Nanning, China

² Department of Ultrosound, Guangxi Medical University Cancer Hospital, Nanning, China

³ Department of Gastroenterology, Medical School of National and Kapodistrian University of Athens, General Hospital of Athens “Laiko”, Athens, Greece

EJMO 2022, 6(1), 25–29; https://doi.org/10.14744/ejmo.2022.25618

Submitted: 10 February 2022 | Accepted: 7 March 2022 | Published: 10 March 2022

© 2022 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( https://creativecommons.org/licenses/by-nc/4.0/ )

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Abstract

Objectives: Targeted agents combined with immune checkpoint inhibitors (ICIs) for advanced hepatocellular carcinoma (HCC) may improve survival for some patients. This study aims to identify the patients who are most likely to
benefit from combination therapy.

Methods: The study included 45 patients receiving lenvatinib while other 65 patients receiving lenvatinib plus ICIs between January 2019 and August 2020. Clinical and laboratory data were evaluated and compared.

Results: The median follow-up was 20.5 months in the lenvatinib and 18.0 months in the combination group. The corresponding median overall survival was 9.3 and 13.0 months (p=0.004), respectively. Subgroup analyses found that lenvatinib plus ICIs was associated with better overall survival in patients younger than 60 years, males, without MAFLD as well as with BMI <23 kg/m2 , cirrhosis, HBV infection, total tumor volume ≥982 cm3, tumor burden score of ≥10.4 or α-fetoprotein ≥200 ng/ml.

Conclusion: Lenvatinib plus ICIs therapy seems to be more effective in advanced HCC patients with viral etiology, low BMI, or high tumor load.

Keywords

Hepatocellular carcinoma

Immune checkpoint inhibitors

Lenvatinib

Overall survival

Conflict of interest

Dr Papatheodoridis has served as lecturer/advisor for Bayern, Ipsen and Roche; the other authors have nothning to disclose.

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