Premium
Lenvatinib is independently associated with the reduced risk of progressive disease when compared with sorafenib in patients with advanced hepatocellular carcinoma
Author(s) -
Kim Soojin,
Kim Kyung Hyun,
Kim Beom Kyung,
Park Jun Yong,
Ahn Sang Hoon,
Kim Do Young,
Kim Seung Up
Publication year - 2021
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.15355
Subject(s) - lenvatinib , sorafenib , medicine , hepatocellular carcinoma , hazard ratio , oncology , confidence interval , progressive disease , gastroenterology , disease
Background and Aims Recently, lenvatinib demonstrated non‐inferiority to sorafenib in terms of overall survival (OS) in a randomized phase III study that was conducted at 154 sites in 20 countries. Here, we investigated treatment outcomes and safety of lenvatinib compared with sorafenib and identified independent predictors of poor outcomes, including shorter progression‐free survival (PFS) and OS in Korean patients with unresectable hepatocellular carcinoma (HCC). Methods Patients with advanced HCC treated with lenvatinib or sorafenib at Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine between October 2018 to October 2019 were considered eligible. Response evaluation was performed according to the modified Response Evaluation Criteria in Solid Tumors. Results The lenvatinib arm had a significantly lower proportion of patients who received prior anti‐HCC treatments (47.7% vs 78.7%; P < 0.001) than those in the sorafenib arm. Univariate analysis showed that ECOG 1 ( vs 0), serum albumin, alpha‐fetoprotein (AFP), previous anti‐HCC treatments, and lenvatinib ( vs sorafenib) were significant predictors of progressive disease (all P < 0.05). In the subsequent multivariate analysis, ECOG 1 ( vs 0) (hazard ratio [HR] = 4.721, 95% confidence interval [CI] 1.371–16.259; P = 0.014), higher AFP level (HR = 1.000, 95% CI 1.000–1.000; P = 0.015), and lenvatinib treatment ( vs sorafenib) (HR = 0.461, 95% CI 0.264–0.804; P = 0.006) independently predicted a higher probability of progressive disease. Conclusions Patients treated with lenvatinib demonstrated significantly longer PFS than those treated with sorafenib. Furthermore, no significant differences were observed in mortality rates between the two groups, which indicated that lenvatinib is non‐inferior to sorafenib in terms of OS.