Lee Shou-Wu, Yang Sheng-Shun, Lien Han-Chung, Peng Yen-Chun, Ko Chung-Wang, Lee Teng-Yu
Division of Gastroenterology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 40705, Taiwan.
Department of Internal Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
J Clin Med. 2022 Mar 6;11(5):1444. doi: 10.3390/jcm11051444.
Currently, atezolizumab combined with bevacizumab is the standard first-line treatment for unresectable hepatocellular carcinoma (HCC), but lenvatinib or sorafenib are still recommended for these patients for some reasons. The aim of the study was to determine the outcomes of Taiwanese patients with advanced-stage HCC who received lenvatinib or sorafenib.
Data on patients with BCLC stage C HCC who were receiving lenvatinib or sorafenib as the first-line therapy from May 2018 to August 2020 was collected. The individuals with lenvatinib and sorafenib were propensity score-matched at a ratio of 1:2.
A total of 22 patients with lenvatinib and 44 patients with sorafenib were enrolled. The ORR (36.4% vs. 11.4%, = 0.023) and DCR (81.9% vs. 56.9%, = 0.039) were both higher in the lenvatinib group compared with the sorafenib group. The median overall survival (OS) of the lenvatinib group and the sorafenib group was 9.36 months and 8.36 months, respectively. The best median OS was detected in patients receiving lenvatinib and having an objective tumor response (11.29 months), with a significant difference ( = 0.031) compared with the other groups.
Lenvatinib, compared to sorafenib, had better ORR and DCR, but similar OS, in Taiwanese patients with advanced-stage HCC. The patients with an objective tumor response had a better OS.
目前，阿替利珠单抗联合贝伐单抗是不可切除肝细胞癌（HCC）的标准一线治疗方案，但由于某些原因，乐伐替尼或索拉非尼仍被推荐用于这些患者。本研究的目的是确定接受乐伐替尼或索拉非尼治疗的台湾晚期HCC患者的治疗结果。
收集2018年5月至2020年8月接受乐伐替尼或索拉非尼作为一线治疗的BCLC C期HCC患者的数据。将乐伐替尼组和索拉非尼组的患者按1:2的比例进行倾向评分匹配。
共纳入22例接受乐伐替尼治疗的患者和44例接受索拉非尼治疗的患者。与索拉非尼组相比，乐伐替尼组的客观缓解率（ORR，36.4% vs. 11.4%，P = 0.023）和疾病控制率（DCR，81.9% vs. 56.9%，P = 0.039）均更高。乐伐替尼组和索拉非尼组的中位总生存期（OS）分别为9.36个月和8.36个月。接受乐伐替尼治疗且有客观肿瘤反应的患者的最佳中位OS为11.29个月，与其他组相比有显著差异（P = 0.031）。
在台湾晚期HCC患者中，与索拉非尼相比，乐伐替尼具有更好的ORR和DCR，但OS相似。有客观肿瘤反应的患者OS更好。
