乐伐替尼在非病毒性不可切除肝细胞癌中的治疗效果。
Therapeutic efficacy of lenvatinib in nonviral unresectable hepatocellular carcinoma.
作者信息
Tomonari Tetsu, Sato Yasushi, Tanaka Hironori, Mitsuhashi Takeshi, Hirao Akihiro, Tanaka Takahiro, Taniguchi Tatsuya, Okamoto Koichi, Sogabe Masahiro, Miyamoto Hiroshi, Muguruma Naoki, Takayama Tetsuji
机构信息
Department of Gastroenterology and Oncology, Institute of Biomedical Sciences Tokushima University Graduate School Tokushima Japan.
Department of Community Medicine for Gastroenterology and Oncology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan.
出版信息
JGH Open. 2021 Oct 22;5(11):1275-1283. doi: 10.1002/jgh3.12663. eCollection 2021 Nov.
AIM
To investigate the therapeutic effect of lenvatinib (LEN) in liver disease etiology, especially nonviral hepatocellular carcinoma (HCC).
METHODS AND RESULTS
Sixty-seven patients with unresectable advanced HCC (u-HCC) treated with LEN and consisting of 26 hepatitis C virus (HCV), 19 hepatitis B virus (HBV), 11 alcohol, and 11 nonalcoholic steatohepatitis (NASH) cases were retrospectively recruited. Univariate and multivariate Cox proportional hazard models were used to determine predictive factors for survival. The objective response rate in the nonviral (alcohol and NASH) group was higher than that in the viral group (59.1% [13/22] vs. 46.7% [21/45]). Progression-free survival was significantly longer in the nonviral group than in the viral group (13.7 vs. 6.6 months; hazard ratio [HR] 0.324; 95% confidence interval [CI] 0.174-0.602; < 0.01). Similarly, median overall survival (OS) was significantly longer in the nonviral group than in the viral group (not evaluable vs. 15.9 months; HR = 0.277; 95% CI = 0.116-0.662; < 0.01). Multivariate analysis revealed that portal vein invasion (HR = 5.327, = 0.0025), treatment line (HR = 0.455, = 0.023), and etiology (HR = 0.180, = 0.00055) were significant independent factors associated with OS in u-HCC patients treated with LEN.
CONCLUSION
Our results suggest that LEN is more effective against nonviral u-HCC than against viral u-HCC.
目的
研究乐伐替尼（LEN）在肝脏疾病病因，尤其是非病毒性肝细胞癌（HCC）中的治疗效果。
方法与结果
回顾性纳入67例接受LEN治疗的不可切除晚期HCC（u-HCC）患者，其中包括26例丙型肝炎病毒（HCV）、19例乙型肝炎病毒（HBV）、11例酒精性和11例非酒精性脂肪性肝炎（NASH）病例。采用单因素和多因素Cox比例风险模型确定生存预测因素。非病毒性（酒精性和NASH）组的客观缓解率高于病毒性组（59.1%[13/22]对46.7%[21/45]）。非病毒性组的无进展生存期显著长于病毒性组（13.7对6.6个月；风险比[HR]0.324；95%置信区间[CI]0.174 - 0.602；P<0.01）。同样，非病毒性组的中位总生存期（OS）显著长于病毒性组（不可评估对15.9个月；HR = 0.277；95%CI = 0.116 - 0.662；P<0.01）。多因素分析显示，门静脉侵犯（HR = 5.327，P = 0.0025）、治疗线数（HR = 0.455，P = 0.023）和病因（HR = 0.180，P = 0.00055）是接受LEN治疗的u-HCC患者OS的显著独立相关因素。
结论
我们的结果表明，LEN对非病毒性u-HCC比病毒性u-HCC更有效。
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