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Safety and efficacy of lenvatinib in elderly patients with unresectable hepatocellular carcinoma: A multicenter analysis with propensity score matching
Author(s) -
Tada Toshifumi,
Kumada Takashi,
Hiraoka Atsushi,
Michitaka Kojiro,
Atsukawa Masanori,
Hirooka Masashi,
Tsuji Kunihiko,
Ishikawa Toru,
Takaguchi Koichi,
Kariyama Kazuya,
Itobayashi Ei,
Tajiri Kazuto,
Shimada Noritomo,
Shibata Hiroshi,
Ochi Hironori,
Toyoda Hidenori,
Nouso Kazuhiro,
Tsutsui Akemi,
Nagano Takuya,
Itokawa Norio,
Hayama Korenobu,
Imai Michitaka,
Joko Kouji,
Koizumi Yohei,
Hiasa Yoichi
Publication year - 2020
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13427
Subject(s) - medicine , lenvatinib , hazard ratio , adverse effect , confidence interval , hepatocellular carcinoma , propensity score matching , proteinuria , proportional hazards model , sorafenib , kidney
Aim Lenvatinib has become available as first‐line therapy for patients with unresectable hepatocellular carcinoma (HCC). However, the safety and efficacy of lenvatinib in elderly patients with HCC has not been sufficiently investigated. We compared the frequency of adverse events and prognosis between elderly and non‐elderly patients with HCC who received lenvatinib. Methods A total of 100 patients with HCC who received lenvatinib were selected using propensity score matching: 50 patients were elderly (age ≥75 years) and 50 patients were non‐elderly. Results In the elderly group, >20% of patients experienced fatigue (36.0%), decreased appetite (26.0%), hypothyroidism (24.0%), proteinuria (22.0%), palmar‐plantar erythrodysesthesia (22.0%), and hypertension (20.0%) of any grade as treatment‐related adverse events. In addition, >10% of patients experienced grade ≥3 treatment‐related fatigue (12.0%). In the non‐elderly group, >20% of patients experienced palmar‐plantar erythrodysesthesia (42.0%), fatigue (28.0%), decreased appetite (22.0%), and diarrhea (20.0%) of any grade as treatment‐related adverse events. In addition, >10% of patients experienced grade ≥3 treatment‐related proteinuria (10.0%). There were no significant differences between the elderly and non‐elderly groups in the frequency of adverse events. Regarding overall and progression‐free survival, there were no significant differences between the elderly and non‐elderly groups (hazard ratio 0.972, 95% confidence interval 0.374–2.529; and hazard ratio 1.362, 95% confidence interval 0.687–2.700, respectively). Palmar‐plantar erythrodysesthesia (hazard ratio 0.117, 95% confidence interval 0.015–0.916) was independently associated with overall survival in a multivariate analysis. Conclusions Lenvatinib can be used safely and efficaciously regardless of age in patients with HCC.