Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab  for Unresectable Hepatocellular Carcinoma

Yano, S.; Kawaoka, T.; Yamasaki, S.; Johira, Y.; Kosaka, M.; Shirane, Y.; Miura, R.; Amioka, K.; Naruto, K.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Nakahara, T.; Murakami, E.; Miki, D.; Tsuge, M.; Teraoka, Y.; Kouno, H.; Takaki, S.; Mori, N.; Tsuji, K.; Oka, S. Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma. Cancers 2023, 15, 5406. Yano, S.; Kawaoka, T.; Yamasaki, S.; Johira, Y.; Kosaka, M.; Shirane, Y.; Miura, R.; Amioka, K.; Naruto, K.; Yamaoka, K.; Fujii, Y.; Uchikawa, S.; Fujino, H.; Ono, A.; Nakahara, T.; Murakami, E.; Miki, D.; Tsuge, M.; Teraoka, Y.; Kouno, H.; Takaki, S.; Mori, N.; Tsuji, K.; Oka, S. Therapeutic Efficacy and Safety of Lenvatinib after Atezolizumab Plus Bevacizumab for Unresectable Hepatocellular Carcinoma. Cancers 2023, 15, 5406.

Abstract

A total of 137 HCC patients treated with atezolizumab plus bevacizumab from October 2020 to September 2022 were enrolled. The median overall survival (OS) and progression-free survival (PFS) from the beginning of atezolizumab plus bevacizumab was 21.1 months (range, 18.8 months-not reached) and 10.5 months (range, 8.2‒12.1 months), respectively. Fifty patients were diagnosed with progressive disease after atezolizumab plus bevacizumab. Of this group, 24 patients were administered lenvatinib, and the median OS and PFS from the beginning of lenvatinib were 15.3 months (range, 10.3 months-not reached) and 4.0 months (range, 2.5‒6.4 months), respectively. The objective response rates based on response evaluation criteria in solid tumors (RECIST) criteria version 1.1 and modified RECIST were 33.3% and 54.2%, respectively. On multivariate analysis, Child-Pugh class A (hazard ratio 0.02, 95% confidence interval (CI) 0.02‒0.76, p = 0.02) and intrahepatic tumor occupancy rate <50% (hazard ratio <0.01, 95% CI 0.003‒0.35, p <0.01) were the significant factors for OS. There were some frequent adverse events (AEs) in patients treated with lenvatinib such as hypertension, fatigue, anorexia, proteinuria, and so on, but none directly caused death. In conclusion, lenvatinib after atezolizumab plus bevacizumab for unresectable HCC should be considered an effective treatment option.

Keywords

hepatocellular carcinoma; unresectable; atezolizumab plus bevacizumab; lenvatinib

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

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.

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