Open AccessBaseline serum angiopoietin-2 and VEGF levels predict the deterioration of the liver functional reserve during lenvatinib treatment for hepatocellular carcinoma
Author(s) -
Taku Shigesawa,
Goki Suda,
Megumi Kimura,
Osamu Maehara,
Akinori Kubo,
Ryoichi Yamada,
Ken Furuya,
Masaru Baba,
Takashi Kitagataya,
Kazuharu Suzuki,
Masatsugu Ohara,
Naoki Kawagishi,
Masato Nakai,
Takuya Sho,
Mitsuteru Natsuizaka,
Kenichi Morikawa,
Koji Ogawa,
Naoya Sakamoto
Publication year - 2021
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0247728
Subject(s) - lenvatinib , hepatocellular carcinoma , medicine , gastroenterology , angiopoietin 2 , vascular endothelial growth factor , liver disease , carcinoma , progressive disease , urology , oncology , vegf receptors , sorafenib , disease
A deteriorated liver functional reserve during systemic therapy for unresectable hepatocellular carcinoma (HCC) causes poor patient outcomes. We aimed to identify predictive factors associated with the deterioration of Child-Pugh score at 8 weeks after lenvatinib initiation. Patients with adequate clinical data and baseline preserved serum samples available were included. Baseline fibroblast growth factor (FGF)19 and 21, angiopoietin (ANG)2, and vascular endothelial growth factor (VEGF) levels were evaluated. Thirty-seven patients were included, and 6, 15, 14, and 2 experienced complete response, partial response, stable disease, and progressive disease, respectively. Twenty-four (65%) and 13 (35%) patients showed a maintained/improved and deteriorated Child-Pugh-score, respectively. While baseline clinical data, treatment response, and laboratory data were similar between these two patient groups, baseline ANG2 and VEGF levels were significantly higher ( P = 0.0017) and lower ( P = 0.0231), respectively, in patients with deteriorated Child-Pugh score than in those without. Based on receiver operating characteristic curve analysis, cut-off values for ANG2 and VEGF were found to be 3,108 pg/mL and 514.9 pg/mL, respectively. Among patients with low VEGF and high ANG2, 89% (8/9) exhibited a deteriorated Child-Pugh score, whereas none of the patients (0/9) with high VEGF and low ANG2 did. The deterioration of the Child-Pugh score in patients with unresectable HCC who are treated with lenvatinib may be predictable based on combined baseline serum ANG2 and VEGF levels.