ALBI分级是肝细胞癌中因不良事件导致乐伐替尼治疗中断的一个预测因素。

ALBI Grade Is a Predictive Factor of Lenvatinib Treatment Discontinuation due to Adverse Events in Hepatocellular Carcinoma.

作者信息

Enomoto Daichi, Yamamoto Kazuhiro, Matsumoto Yuki, Morioka Asami, Omura Tomohiro, Komatsu Shohei, Yano Yoshihiko, Fukumoto Takumi, Yano Ikuko

机构信息

Department of Pharmacy, Kobe University Hospital, Kobe, Japan.

Department of Pharmacy, Kobe University Hospital, Kobe, Japan;

出版信息

Anticancer Res. 2023 Mar;43(3):1317-1323. doi: 10.21873/anticanres.16279.

DOI:10.21873/anticanres.16279

PMID:36854508

Abstract

BACKGROUND/AIM: Lenvatinib is a multiple-tyrosine kinase inhibitor used to treat hepatocellular carcinoma (HCC), and its systematic concentration varies according to liver function. The albumin-bilirubin (ALBI) grade is a novel indicator for predicting liver function in patients with hepatic disease. This study aimed to investigate the relationship between ALBI grade and HCC patients' lenvatinib treatment duration.

PATIENTS AND METHODS

This is a retrospective cohort study of patients with HCC and Child-Pugh A treated with lenvatinib between April 2018 and December 2019. The baseline liver function was determined using the ALBI grade. The primary outcome was discontinuation owing to adverse events. The risk factors for discontinuation owing to adverse effects were analyzed using logistic regression.

RESULTS

This investigation included 48 HCC patients. Patients with ALBI grade 2 had a significantly shorter time of discontinuation due to adverse events than those with grade 1 (p=0.036). However, the time of treatment failure did not differ between the groups. Multiple logistic regression analysis showed that ALBI grade 2 and non-use of antihypertensive drugs were independent factors for discontinuation due to adverse events [odds ratio (OR)=14.1, 95% confidence interval (CI)=1.46-135, p=0.022 and OR=5.48, 95% CI=1.13-23.9, p=0.024, respectively].

CONCLUSION

The ALBI grades may be useful in predicting adverse events caused by lenvatinib in patients with HCC and Child-Pugh A.

摘要

背景/目的：仑伐替尼是一种用于治疗肝细胞癌（HCC）的多靶点酪氨酸激酶抑制剂，其血药浓度会因肝功能不同而有所变化。白蛋白-胆红素（ALBI）分级是预测肝病患者肝功能的一项新指标。本研究旨在探讨ALBI分级与HCC患者仑伐替尼治疗持续时间之间的关系。

患者与方法

这是一项回顾性队列研究，研究对象为2018年4月至2019年12月期间接受仑伐替尼治疗的HCC且Child-Pugh A级患者。采用ALBI分级确定基线肝功能。主要结局是因不良事件而停药。使用逻辑回归分析因不良反应而停药的危险因素。

结果

本研究纳入了48例HCC患者。ALBI 2级患者因不良事件停药的时间明显短于1级患者（p=0.036）。然而，两组间治疗失败时间无差异。多因素逻辑回归分析显示，ALBI 2级和未使用降压药物是因不良事件停药的独立因素[比值比（OR）=14.1，95%置信区间（CI）=1.46-135，p=0.022；OR=5.48，95%CI=1.13-23.9，p=0.024]。