Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan
Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Anticancer Res. 2020 Apr;40(4):2283-2290. doi: 10.21873/anticanres.14193.
BACKGROUND/AIM: We aimed to compare the outcomes between sorafenib and lenvatinib as first-line therapy for advanced hepatocellular carcinoma (HCC) with major portal vein tumor thrombosis (Vp3/4).
This retrospective study enrolled 41 HCC patients with Vp3/4 and Child-Pugh A.
The outcomes in the lenvatinib group (n=13) were significantly better than those in the sorafenib group (n=28) [best objective response rate according to the modified Response Evaluation Criteria in Solid Tumors: 53.8% vs. 14.3%; p=0.0193, best disease control rate: 92.3% vs. 35.7%; p=0.0008, median overall survival (OS): not reached vs. 187 days; p=0.0040, respectively]. Lenvatinib treatment was the only significant predictor of better OS and time to tumor progression. No patient needed to discontinue lenvatinib treatment due to drug-related adverse events.
Compared with sorafenib, lenvatinib treatment for advanced HCC with Vp3/4 may lead to more favorable outcomes.
背景/目的：我们旨在比较索拉非尼和仑伐替尼作为伴有主门静脉癌栓（Vp3/4）的晚期肝细胞癌（HCC）一线治疗的疗效。
本回顾性研究纳入了 41 例伴有 Vp3/4 和 Child-Pugh A 的 HCC 患者。
仑伐替尼组（n=13）的结果明显优于索拉非尼组（n=28）[根据实体瘤反应评价标准的改良版，最佳客观缓解率：53.8%比 14.3%；p=0.0193，最佳疾病控制率：92.3%比 35.7%；p=0.0008，中位总生存期（OS）：未达到比 187 天；p=0.0040]。仑伐替尼治疗是 OS 和肿瘤进展时间更好的唯一显著预测因素。没有患者因药物相关不良反应而需要停止仑伐替尼治疗。
与索拉非尼相比，仑伐替尼治疗伴有 Vp3/4 的晚期 HCC 可能会带来更有利的结果。
