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Lenvatinib with or without concurrent drug-eluting beads transarterial chemoembolization in patients with unresectable, advanced hepatocellular carcinoma: A real-world, multicenter, retrospective study
Liver Cancer ( IF 13.8 ) Pub Date : 2022-03-09 , DOI: 10.1159/000523849
Dongdong Xia 1, 2 , Wei Bai 1, 2 , Enxin Wang 1, 3 , Jiaping Li 4 , Xiaoming Chen 5 , Zhexuan Wang 2 , Mingsheng Huang 6 , Ming Huang 7 , Junhui Sun 8 , Weizhu Yang 9 , Zhengyu Lin 10 , Jianbing Wu 11 , Zixiang Li 12 , Shufa Yang 13 , Xu Zhu 14 , Zaizhong Chen 15 , Yanfang Zhang 16 , Wenzhe Fan 4 , Qicong Mai 5 , Rong Ding 7 , Chunhui Nie 8 , Long Feng 11 , Xueda Li 12 , Wukui Huang 13 , Jun Sun 2 , Qiuhe Wang 2 , Yong Lv 2 , Xiaomei Li 1 , Bohan Luo 1 , Zhengyu Wang 1 , Jie Yuan 1 , Wengang Guo 1 , Kai Li 2 , Bing Li 1 , Ruijun Li 1 , Zhanxin Yin 1 , Jielai Xia 17 , Guohong Han 1, 2
Affiliation  

Introduction: Lenvatinib is the first-line treatment for advanced hepatocellular carcinoma (HCC). We aimed to compare the clinical outcomes of lenvatinib plus drug-eluting beads transarterial chemoembolization (DEB-TACE) versus lenvatinib alone in real-world practice. Methods: This retrospective analysis included 142 consecutive patients who received lenvatinib plus DEB-TACE and 69 patients who received lenvatinib alone as first-line treatment from 15 Chinese academic centers from Nov 2018 to Nov 2019. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR) evaluated by mRECIST criteria, and safety profiles were compared between the two groups. Results: The median OS and PFS were significantly longer in the combined therapy group than in the monotherapy group in whole cohort (median OS, 15.9 vs 8.6 months, p=0.0022; median PFS, 8.6 vs 4.4 months, p<0.001) and after propensity score matching analysis (median OS, 13.8 vs 7.8 months, p=0.03; median PFS, 7.8 vs 4.5 months, p=0.009). Moreover, the treatment option was an independent prognostic factor for OS and PFS with adjustment based upon baseline characteristics (adjusted hazard ratio [HR]=0.53, 95% confidence interval [CI]: 0.36–0.78, p=0.001, and adjusted HR=0.42, 95% CI: 0.30–0.60, p<0.001, respectively) and propensity score (adjusted HR=0.52, 95% CI: 0.36–0.76, p=0.001, and adjusted HR=0.46, 95% CI: 0.33-0.64, p<0.001, respectively). Moreover, a greater ORR was observed in the combined group (ORR=46.48% vs. 13.05%, p<0.001). Furthermore, the most common adverse events were elevated AST (54.9%) and fatigue (46.4%) in the lenvatinib plus DEB-TACE group and lenvatinib group, respectively. Most adverse events were mild-to-moderate and manageable. Conclusions: With well-tolerated safety, lenvatinib plus DEB-TACE was more effective than lenvatinib monotherapy in improving OS, PFS, and ORR. Thus, it may be a promising treatment for advanced HCC. Future prospective studies confirming these findings are warranted.
更新日期:2022-03-09
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