Department of Internal Medicine I, University Hospital Bonn, Bonn, Germany.
Department of Internal Medicine B, University Hospital Münster, Münster, Germany.
Sci Rep. 2024 Sep 27;14(1):22146. doi: 10.1038/s41598-024-66766-8.
Lenvatinib is a multiple receptor tyrosine kinase inhibitor (TKI) approved for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). TKI are suspected of exacerbating muscle loss in patients with cancer. In this study, we analyze the role of muscle loss in patients with advanced HCC treated with lenvatinib. This is a retrospective analysis of a real-life cohort of 25 patients with advanced HCC who were treated with lenvatinib from 2018 to March 2021 in Germany. Patients were stratified for loss of skeletal muscle area during the first three months of lenvatinib therapy. Overall survival (OS), progression-free survival (PFS) and toxicity were analyzed for all patients, especially regarding loss of muscle before and during the first three months of therapy with lenvatinib. Three months after beginning of therapy with lenvatinib, a significant reduction of muscle mass was observed in 60% of patients (p = 0.035). Despite increase of loss of skeletal muscle, patients benefitted from lenvatinib in our cohort of patients in terms of OS and PFS and did not experience increased toxicity. Furthermore, muscle loss was not a negative predictor of survival in the univariate analysis (p = 0.675). Patients with advanced hepatocellular carcinoma experience muscle loss with lenvatinib therapy. However, despite progressive muscle loss, patients benefit from a therapy with lenvatinib in terms of OS and PFS without increased toxicity. However, assessment and prophylaxis of skeletal muscle status should be recommended during a therapy with lenvatinib.
仑伐替尼是一种多受体酪氨酸激酶抑制剂（TKI），已被批准用于不可切除肝细胞癌（HCC）患者的一线治疗。TKI 被怀疑会加剧癌症患者的肌肉减少。在这项研究中，我们分析了接受仑伐替尼治疗的晚期 HCC 患者肌肉减少的作用。这是一项回顾性分析，纳入了 2018 年至 2021 年 3 月期间在德国接受仑伐替尼治疗的 25 例晚期 HCC 患者的真实队列。根据仑伐替尼治疗的前三个月内骨骼肌面积的丧失情况对患者进行分层。对所有患者进行了总体生存（OS）、无进展生存（PFS）和毒性分析，特别是在接受仑伐替尼治疗之前和前三个月期间肌肉减少的情况。开始仑伐替尼治疗三个月后，60%的患者观察到肌肉质量显著减少（p=0.035）。尽管骨骼肌丢失增加，但在我们的患者队列中，患者从仑伐替尼治疗中获益，OS 和 PFS 得到改善，并且没有增加毒性。此外，肌肉减少在单因素分析中不是生存的负预测因素（p=0.675）。接受仑伐替尼治疗的晚期肝细胞癌患者会出现肌肉减少。然而，尽管肌肉不断减少，患者在接受仑伐替尼治疗时在 OS 和 PFS 方面受益，而没有增加毒性。然而，在仑伐替尼治疗期间，应该推荐评估和预防骨骼肌状况。
