Division of Gastroenterology and Hepatology, Department of Internal Medicine (Omori), School of Medicine, Faculty of Medicine, Toho University, Tokyo, Japan.
Department of Medical Biochemistry, Faculty of Pharmaceutical Sciences, Toho University, Chiba, Japan.
Oncology. 2023;101(10):634-644. doi: 10.1159/000531562. Epub 2023 Jun 26.
Previously, we reported that the tyrosine kinase inhibitor (TKI) sorafenib decreases serum levels of carnitine and reduces skeletal muscle volume. Moreover, others reported that TKIs might lead to cardiomyopathy or heart failure. Therefore, this study aimed to evaluate the effects of lenvatinib (LEN) on skeletal muscle volume and cardiac function in patients with hepatocellular carcinoma (HCC).
This retrospective study included 58 adult Japanese patients with chronic liver diseases and HCC treated with LEN. Blood samples were collected before and after 4 weeks of treatment, and serum carnitine fraction and myostatin levels were measured. Before and after 4-6 weeks of treatment, the skeletal muscle index (SMI) was evaluated from computed tomography images and cardiac function was assessed by ultrasound cardiography.
After treatment, SMI, serum levels of total carnitine, and global longitudinal strain were significantly lower, but serum levels of myostatin were significantly higher. Left ventricular ejection fraction showed no significant change.
In patients with HCC, LEN decreases serum levels of carnitine, skeletal muscle volume, and worsens cardiac function.
此前，我们曾报道酪氨酸激酶抑制剂（TKI）索拉非尼可降低肉毒碱的血清水平并减少骨骼肌体积。此外，还有人报道 TKI 可能导致心肌病或心力衰竭。因此，本研究旨在评估仑伐替尼（LEN）对肝细胞癌（HCC）患者骨骼肌体积和心功能的影响。
这是一项回顾性研究，共纳入 58 例接受 LEN 治疗的慢性肝病和 HCC 成年日本患者。在治疗前和治疗后 4 周采集血样，并检测血清肉毒碱分数和肌肉生长抑制素水平。在治疗后 4-6 周，通过计算机断层扫描图像评估骨骼肌指数（SMI），并通过超声心动图评估心功能。
治疗后，SMI、总肉毒碱血清水平和整体纵向应变明显降低，但肌肉生长抑制素血清水平明显升高。左心室射血分数无明显变化。
在 HCC 患者中，LEN 降低了肉毒碱、骨骼肌体积的血清水平，并导致心功能恶化。
