Open AccessLenvatinib with or without Concurrent Drug-Eluting Beads Transarterial Chemoembolization in Patients with Unresectable, Advanced Hepatocellular Carcinoma: A Real-World, Multicenter, Retrospective Study
Author(s) -
Xia Dongdong,
Bai Wei,
Wang Enxin,
Li Jiaping,
Chen Xiaoming,
Wang Zhexuan,
Huang Mingsheng,
Huang Ming,
Sun Junhui,
Yang Weizhu,
Lin Zhengyu,
Wu Jianbing,
Li Zixiang,
Yang Shufa,
Zhu Xu,
Chen Zaizhong,
Zhang Yanfang,
Fan Wenzhe,
Mai Qicong,
Ding Rong,
Nie Chunhui,
Feng Long,
Li Xueda,
Huang Wukui,
Sun Jun,
Wang Qiuhe,
Lv Yong,
Li Xiaomei,
Luo Bohan,
Wang Zhengyu,
Yuan Jie,
Guo Wengang,
Li Kai,
Li Bing,
Li Ruijun,
Yin Zhanxin,
Xia Jielai,
Han Guohong
Publication year - 2022
Publication title -
liver cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.916
H-Index - 34
eISSN - 1664-5553
pISSN - 2235-1795
DOI - 10.1159/000523849
Subject(s) - research article
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 November 2018 to November 2019. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR) were evaluated by modified Response Evaluation Criteria in Solid Tumors 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 (AEs) were elevated aspartate aminotransferase (54.9%) and fatigue (46.4%) in the lenvatinib plus DEB-TACE group and lenvatinib group, respectively. Most AEs 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.