Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study

Jaejun Lee
ORCID logo ,
Ji Won Han
ORCID logo ,
Pil Soo Sung
* ORCID logo ,
Soon Kyu Lee
ORCID logo ,
Hyun Yang
,
Hee Chul Nam
,
Sun Hong Yoo
,
Hae Lim Lee
,
Hee Yeon Kim
,
Sung Won Lee
,
Jung Hyun Kwon
,
Jeong Won Jang
ORCID logo ,
Chang Wook Kim
ORCID logo ,
Soon Woo Nam
,
Jung Suk Oh
,
Ho Jong Chun
,
Si Hyun Bae
,
Jong Young Choi
,
Seung Kew Yoon
ORCID logo
Version 1 : Received: 23 July 2021 / Approved: 26 July 2021 / Online: 26 July 2021 (09:59:34 CEST)

A peer-reviewed article of this Preprint also exists.

Lee, J.; Han, J.-W.; Sung, P.-S.; Lee, S.-K.; Yang, H.; Nam, H.-C.; Yoo, S.-H.; Lee, H.-L.; Kim, H.-Y.; Lee, S.-W.; Kwon, J.-H.; Jang, J.-W.; Kim, C.-W.; Nam, S.-W.; Oh, J.-S.; Chun, H.-J.; Bae, S.-H.; Choi, J.-Y.; Yoon, S.-K. Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study. J. Clin. Med. 2021, 10, 4045. Lee, J.; Han, J.-W.; Sung, P.-S.; Lee, S.-K.; Yang, H.; Nam, H.-C.; Yoo, S.-H.; Lee, H.-L.; Kim, H.-Y.; Lee, S.-W.; Kwon, J.-H.; Jang, J.-W.; Kim, C.-W.; Nam, S.-W.; Oh, J.-S.; Chun, H.-J.; Bae, S.-H.; Choi, J.-Y.; Yoon, S.-K. Comparative Analysis of Lenvatinib and Hepatic Arterial Infusion Chemotherapy in Unresectable Hepatocellular Carcinoma: A Multi-Center, Propensity Score Study. J. Clin. Med. 2021, 10, 4045.

Abstract

The comparative efficacy and safety between lenvatinib and hepatic artery infusion chemotherapy (HAIC) in patients with unresectable hepatocellular carcinoma (HCC) are still unclear. This multicenter historical cohort study enrolled 244 patients who were treated with HAIC (n = 173) or lenvatinib (n = 71) between 2012 and 2020. Propensity score matching (PSM) was performed, and 52 patients were selected per group. Clinical outcomes and safety were compared. Objective response rate (ORR) was not different between the two groups (26.0% vs. 23.1%, P = 0.736). Before PSM, HAIC group had a higher proportion of Child-Pugh B and portal vein tumor, whereas lenvatinib group had more patients with extrahepatic metastases, which was adjusted after PSM. There were no differences in progression-free survival (PFS) and overall survival (OS) after PSM (HAIC vs. lenvatinib, median PFS, 3.6 vs. 4.0 months, P = 0.706; median OS 10.8 vs. 7.9 months, P = 0.106). Multivariate Cox-regression showed that alpha-fetoprotein ≤ 1000 ng/mL was only associated factor for OS after PSM in all patients (hazard ratio = 0.421, P = 0.011). Subgroup analysis for patients with high tumor burden beyond the REFLECT eligibility criteria revealed that HAIC group (n = 29) had a significantly longer OS than did lenvatinib group (n = 30) (10.0 vs. 5.4 months, P=0.004). More patients in HAIC group achieved better liver function than those in lenvatinib group at the time of best responses. There was no difference in the incidence of grade 3 and 4 adverse events between the two groups. Therefore, lenvatinib is comparable to HAIC in terms of ORR and OS in unresectable HCC meeting REFLECT eligibility criteria.

Keywords

Hepatocellular carcinoma; Lenvatinib; Hepatic arterial infusion chemotherapy; Propensity score matching

Subject

Medicine and Pharmacology, Immunology and Allergy

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Download PDF Download Supplementary

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0
Metrics 0
Get PDF Supplementary Files Cite Share 0
Bookmark BibSonomy Mendeley Reddit Delicious
×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.