Effectiveness of Lenvatinib Versus Sorafenib for Unresectable Hepatocellular Carcinoma in Patients with Hepatic Decompensation

Min Kyung Park, Yun Bin Lee, Hyemi Moon, Na Ryung Choi, Minseok Albert Kim, Heejoon Jang, Joon Yeul Nam, Eun Ju Cho, Jeong Hoon Lee, Su Jong Yu, Yoon Jun Kim, Jung Hwan Yoon

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background/Aim: Lenvatinib and sorafenib are currently available to treat patients with advanced hepatocellular carcinoma (HCC). However, since the clinical trials evaluating the efficacy of lenvatinib and sorafenib included only patients with Child–Pugh class A, little is known about the effectiveness of the treatments in patients with hepatic decompensation. We compared the effectiveness of lenvatinib and sorafenib in decompensated patients with unresectable HCC. Methods: Consecutive patients who were classified as Child–Pugh class B or C and received lenvatinib or sorafenib as first-line systemic therapy for unresectable HCC between November 2018 and April 2020 at a tertiary referral center were included in this retrospective study. The primary outcome was overall survival (OS), and the secondary outcomes were progression-free survival (PFS), time-to-progression, best overall tumor response, and safety profiles. Results: Among 94 patients, 34 received lenvatinib and 60 received sorafenib. The median OS was 4.1 months (95% confidence interval [CI], 2.9–5.2): 4.2 months (95% CI, 2.9–5.3) for lenvatinib and 4.1 months (95% CI, 2.7–6.4) for sorafenib. The treatment regimen was not associated with significant improvement in OS after adjusting for covariables (adjusted hazard ratio [aHR], 0.92; 95% CI, 0.54–1.54; P = 0.74). The treatment regimen was not an independent predictor of PFS (lenvatinib vs. sorafenib; aHR, 0.77; 95% CI, 0.48–1.24; P = 0.28). HRs were maintained even after balancing with the inverse probability treatment weighting method. Objective response rates were 11.8% and 6.7% in patients receiving lenvatinib and sorafenib, respectively (P = 0.45). Ten patients in both groups (five in the lenvatinib group and five in the sorafenib group) underwent dose modification due to adverse events, and significant difference was not observed between the treatment groups (P = 0.49). Conclusion: The effectiveness of lenvatinib and sorafenib was comparable for the treatment of unresectable HCC in decompensated patients.

Original languageEnglish
Pages (from-to)4939-4949
Number of pages11
JournalDigestive Diseases and Sciences
Volume67
Issue number10
DOIs
StatePublished - Oct 2022

Keywords

  • Chemotherapy
  • Child–Pugh classification
  • Liver cancer
  • Survival
  • Targeted therapy

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