Promsorn Panuwat, Yamaguchi Takashi, Kosaka Hisashi, Aoi Kazunori, Yoshida Katsunori, Matsushima Hideyuki, Matsui Kosuke, Shimoda Shinji, Kaibori Masaki, Naganuma Makoto
Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Osaka 573-1101, Japan.
Department of Surgery, Kansai Medical University, Hirakata, Osaka 573-1010, Japan.
Mol Clin Oncol. 2024 Jul 10;21(3):63. doi: 10.3892/mco.2024.2761. eCollection 2024 Sep.
Recently, the relationship between the relative dose intensity (RDI) and efficacy was demonstrated for lenvatinib therapy in patients with advanced hepatocellular carcinoma (HCC), with a higher RDI of lenvatinib monotherapy indicating a higher efficacy. However, not every patient can tolerate a high RDI during the course of treatment; therefore, add-on combination therapy may be necessary for patients requiring a low RDI. The addition of transarterial chemoembolization (TACE) to lenvatinib therapy improves clinical outcomes. Therefore, the aim of the present study was to compare the clinical outcomes of lenvatinib plus TACE (the LEN-TACE group) with those of lenvatinib alone (the LEN group) in patients with unresectable HCC with a high- or low-RDI. A total of 66 patients with advanced HCC were enrolled in the present retrospective study. Eligible patients were those who initiated lenvatinib monotherapy between April 2018 and September 2020. Of these patients, 29 had an 8-week RDI of ≥60%, 6 of which received LEN-TACE. A further 37 patients had an 8-week RDI of <60%, 7 of which received LEN-TACE. In the high-RDI group, both the radiological evaluations and the overall survival (OS) time were improved in those in the low-RDI group. In addition, the median OS of patients treated with LEN-TACE was longer compared with that of patients treated with lenvatinib alone in the low-RDI group (P=0.0467). Therefore, the results of the present study revealed that early TACE should be considered instead of continuing lenvatinib only treatment in patients receiving an insufficient dose of lenvatinib, such as those with an 8-week RDI of <60%.
最近，在晚期肝细胞癌（HCC）患者中，已证实乐伐替尼治疗的相对剂量强度（RDI）与疗效之间的关系，乐伐替尼单药治疗的RDI越高，疗效越高。然而，并非每个患者在治疗过程中都能耐受高RDI；因此，对于需要低RDI的患者，可能需要联合治疗。在乐伐替尼治疗中加入经动脉化疗栓塞术（TACE）可改善临床结局。因此，本研究的目的是比较乐伐替尼联合TACE（LEN-TACE组）与单纯乐伐替尼（LEN组）在高或低RDI不可切除HCC患者中的临床结局。本项回顾性研究共纳入66例晚期HCC患者。符合条件的患者为2018年4月至2020年9月开始乐伐替尼单药治疗的患者。在这些患者中，29例8周RDI≥60%，其中6例接受LEN-TACE治疗。另外37例患者8周RDI<60%，其中7例接受LEN-TACE治疗。在高RDI组中，低RDI组患者的影像学评估和总生存（OS）时间均得到改善。此外，在低RDI组中，接受LEN-TACE治疗的患者的中位OS比单纯接受乐伐替尼治疗的患者更长（P=0.0467）。因此，本研究结果显示，对于接受乐伐替尼剂量不足的患者，如8周RDI<60%的患者，应考虑早期TACE治疗，而不是继续单纯乐伐替尼治疗。
