Open AccessEarly radiological response evaluation with response evaluation criteria in solid tumors 1.1 stratifies survival in hepatocellular carcinoma patients treated with lenvatinib
Author(s) -
Kaneko Shun,
Tsuchiya Kaoru,
Yasui Yutaka,
Inada Kento,
Kirino Sakura,
Yamashita Koji,
Osawa Leona,
Hayakawa Yuka,
Sekiguchi Shuhei,
Higuchi Mayu,
Takaura Kenta,
Maeyashiki Chiaki,
Tamaki Nobuharu,
Takeguchi Takaya,
Takeguchi Yuko,
Nakanishi Hiroyuki,
Itakura Jun,
Takahashi Yuka,
Himeno Yoshiro,
Kurosaki Masayuki,
Izumi Namiki
Publication year - 2020
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12420
Subject(s) - medicine , response evaluation criteria in solid tumors , hepatocellular carcinoma , lenvatinib , hazard ratio , confidence interval , radiological weapon , radiology , univariate analysis , multivariate analysis , nuclear medicine , oncology , progressive disease , chemotherapy , sorafenib
Background and Aim Lenvatinib (LEN) has an antitumor effect with an early reduction in contrast enhancement for unresectable hepatocellular carcinoma (HCC). The aim of this study was to reveal the most useful radiological response evaluation for overall survival (OS) in patients treated with LEN. Methods Patients receiving LEN therapy ( n = 80) were retrospectively recruited from April 2018 to January 2020. Enhanced computed tomography scans were performed at baseline and every 4–8 weeks. OS and radiological response were evaluated using response evaluation criteria in solid tumors (RECIST 1.1), modified RECIST (mRECIST), and Choi criteria. To be eligible for study, a minimal cumulative duration of LEN was 4 weeks. A total of 62 patients were included in the analysis. Results The median OS was 469 days. The RECIST 1.1, mRECIST, and Choi criteria identified 14 (22.5%), 30 (48.3%), and 33 (53.2%) patients with an objective response, respectively. In the univariate analysis, Child–Pugh class B, major vascular invasion, and high alpha‐fetoprotein (>200) were statistically significant poor prognostic factors. Radiological response was a significantly better prognostic factor in each criterion (RECIST, mRECIST, and Choi). In the multivariate analysis, radiological response evaluated by RECIST (hazard ratio, 0.259; 95% confidence interval, 0.0723–0.928; P = 0.038) was an independent factor. Furthermore, only RECIST significantly stratified prognosis ( P = 0.041) when limited to the first evaluation. Conclusion RECIST 1.1 was useful even as early therapeutic evaluation for HCC patients treated with LEN. Understanding the characteristics of radiological response over time may contribute to improving the prognosis of patients with HCC.