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  • S. Karger AG  (8)
  • Hirooka, Masashi  (8)
  • 1
    Online Resource
    Online Resource
    Clinical Predictor of Urinary Protein as Adverse Event Associated with Atezolizumab plus Bevacizumab Treatment for Unresectable Hepatocellular Carcinoma
    S. Karger AG ; 2022
    In:  Oncology Vol. 100, No. 12 ( 2022), p. 645-654
    Details
    In: Oncology, S. Karger AG, Vol. 100, No. 12 ( 2022), p. 645-654
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Adverse events (AEs) of urinary protein from monoclonal antibodies against vascular endothelial growth factor are factors that often inhibit systemic therapy for unresectable hepatocellular carcinoma (uHCC). This study aimed to elucidate risk factors of urinary protein in the early period ( & #x3c;12 weeks) of atezolizumab plus bevacizumab treatment (Atez/Bev). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From 2020 to June 2022, 193 uHCC patients treated with Atez/Bev at our affiliated hospitals were enrolled (median 73 years, 158 males, 183 Child-Pugh A, BCLC-0:A:B:C = 1:7:73:112). AEs related to urinary protein (≥G2) within 12 weeks were defined as significant, and related clinical features were analyzed retrospectively. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 In analyses of risk factors of urinary protein-related AEs during the first 12 weeks after starting Atez/Bev using a logistic regression method, univariate analysis showed positive for hypertension (odds ratio [OR] 3.54, 95% CI: 1.28–9.80, 〈 i 〉 p 〈 /i 〉 = 0.015) and baseline urinary protein and urine creatinine ratio (UPC: ≥0.16) (OR: 2.52, 95% CI: 1.09–5.83, 〈 i 〉 p 〈 /i 〉 = 0.031) as pretreatment clinical factors, while elevation of urinary protein in the early period (baseline to 3 weeks) with delta UPC per 3 weeks (ΔUPC/3W) (≥0.23) (OR: 15.80, 95% CI: 6.15–40.50, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) was a clinical factor after starting treatment. Multivariate analysis of only baseline clinical factors revealed positive for history of hypertension as the only predictive factor (OR: 3.20, 95% CI: 1.14–8.95, 〈 i 〉 p 〈 /i 〉 = 0.027), while only ΔUPC/3W (≥0.23) (OR: 14.40, 95% CI: 4.91–42.00, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) were noted in multivariate analysis including ΔUPC/3W. Predictive factors for ΔUPC/3W (≥0.23) were hypertension (OR: 3.50, 95% CI: 1.23–99.90, 〈 i 〉 p 〈 /i 〉 = 0.019) and UPC (≥0.16) (OR: 6.12, 95% CI: 2.61–14.30, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) in multiple analysis. 〈 b 〉 〈 i 〉 Discussion/Conclusion: 〈 /i 〉 〈 /b 〉 Urinary protein-related AEs are frequently observed during Atez/Bev treatment in uHCC patients with elevated ΔUPC/3W (≥0.23), and ΔUPC/3W (≥0.23) is often seen in patients with hypertension and/or UPC (≥0.16).
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000526521
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2022
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 2
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    Impact of Early Lenvatinib Administration on Survival in Patients with Intermediate-Stage Hepatocellular Carcinoma: A Multicenter, Inverse Probability Weighting Analysis
    S. Karger AG ; 2021
    In:  Oncology Vol. 99, No. 8 ( 2021), p. 518-527
    Details
    In: Oncology, S. Karger AG, Vol. 99, No. 8 ( 2021), p. 518-527
    Abstract: 〈 b 〉 〈 i 〉 Aim/Background: 〈 /i 〉 〈 /b 〉 Transarterial chemoembolization (TACE) is recommended for patients with intermediate-stage hepatocellular carcinoma (HCC). In this study, we investigated the impact of early lenvatinib administration in patients with intermediate-stage HCC, especially those with tumors beyond the up-to-7 criteria. 〈 b 〉 〈 i 〉 Materials/Methods: 〈 /i 〉 〈 /b 〉 A total of 208 patients with intermediate-stage HCC whose initial treatment was early lenvatinib administration or TACE were enrolled. Multivariate overall survival analysis was performed in this cohort. In addition, the impact of early lenvatinib administration on survival in patients with HCC beyond the up-to-7 criteria was clarified using inverse probability weighting (IPW) analysis. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The overall cumulative survival rates at 6, 12, 18, and 24 months were 94.4, 79.9, 65.8, and 50.1%, respectively. Multivariate analysis with Cox proportional hazards modeling showed that HCC treatment with lenvatinib (hazard ratio [HR], 0.199; 95% confidence interval [CI] , 0.077–0.517; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), α-fetoprotein ≥100 ng/mL (HR, 1.687), Child-Pugh class B disease (HR, 1.825), and beyond the up-to-7 criteria (HR, 2.016) were independently associated with overall survival. The 6-, 12-, 18-, and 24-month cumulative survival rates were 96.0, 90.4, 65.7, and 65.7%, respectively, in patients treated with lenvatinib, and 94.1, 78.5, 65.3, and 48.4%, respectively, in patients who received TACE ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). In addition, univariate analysis with Cox proportional hazards modeling adjusted by IPW showed that lenvatinib therapy was significantly associated with overall survival in patients with HCC beyond the up-to-7 criteria (HR, 0.230; 95% CI, 0.059–0.904; 〈 i 〉 p 〈 /i 〉 = 0.035). 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Lenvatinib may be a suitable first-line treatment for patients with intermediate-stage HCC beyond the up-to-7 criteria.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000515896
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 3
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    Role of the Prognostic Nutritional Index in Predicting Survival in Advanced Hepatocellular Carcinoma Treated with Atezolizumab Plus Bevacizumab
    S. Karger AG ; 2023
    In:  Oncology Vol. 101, No. 5 ( 2023), p. 283-291
    Details
    In: Oncology, S. Karger AG, Vol. 101, No. 5 ( 2023), p. 283-291
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 The prognostic nutritional index (PNI) is a multiparametric score introduced by Onodera based on the blood levels of lymphocytes and albumin in patients with gastrointestinal neoplasms. Regarding hepatocellular carcinoma (HCC), its prognostic role has been shown in patients treated with sorafenib and lenvatinib. The aim of this real-world study was to investigate the association between clinical outcomes and PNI in patients being treated with atezolizumab plus bevacizumab. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The overall cohort of this multicentric study included 871 consecutive HCC patients from 5 countries treated with atezolizumab plus bevacizumab in first-line therapy. The PNI was calculated as follows: 10 × serum albumin concentration (g/dL) + 0.005 × peripheral lymphocyte count (number/mm 〈 sup 〉 3 〈 /sup 〉 ). 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Data regarding lymphocyte counts and albumin levels were available for 773 patients; therefore, these patients were included in the final analysis. The cut-off point of the PNI was determined to be 41 by receiver operating characteristic analysis. 268 patients (34.7%) were categorized as the PNI-low group, while the remaining 505 (65.3%) patients as the PNI-high group. At the univariate analysis, high PNI was associated with longer overall survival (OS) (22.5 vs. 10.1 months, HR 0.34, 〈 i 〉 p 〈 /i 〉 & #x3c;0.01) and progression-free survival (PFS) (8.7 vs. 5.8 months, HR 0.63, 〈 i 〉 p 〈 /i 〉 & #x3c;0.01) compared to patients with low PNI. At the multivariate analysis, high versus low PNI resulted as an independent prognostic factor for OS (HR 0.49, 〈 i 〉 p 〈 /i 〉 & #x3c;0.01) and PFS (HR 0.82, 〈 i 〉 p 〈 /i 〉 = 0.01). There was no difference in objective response rate between the two groups (high 26.1% vs. low 19.8%, 〈 i 〉 p 〈 /i 〉 = 0.09), while disease control rate was significantly higher in the PNI-high group (76.8% vs. 66.4%, 〈 i 〉 p 〈 /i 〉 = 0.01). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 PNI is an independent prognostic factor for OS and PFS in HCC patients on first-line treatment with atezolizumab plus bevacizumab.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000528818
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483096-6
    detail.hit.zdb_id: 250101-6
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  • 4
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    Lenvatinib as Second-Line Treatment after Atezolizumab plus Bevacizumab for Unresectable Hepatocellular Carcinoma: Clinical Results Show Importance of Hepatic Reserve Function
    S. Karger AG ; 2023
    In:  Oncology Vol. 101, No. 10 ( 2023), p. 624-633
    Details
    In: Oncology, S. Karger AG, Vol. 101, No. 10 ( 2023), p. 624-633
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Lack of an established methodology for post-progression systemic treatment following atezolizumab plus bevacizumab (Atez/Bev) administration is an important clinical issue. The present study aimed to elucidate the potential of lenvatinib as a second-line treatment option after Atez/Bev failure. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From 2020 to 2022, 101 patients who received lenvatinib as second-line treatment were enrolled (median 72 years, males 77, Child-Pugh A 82, BCLC-A:B:C:D = 1:35:61:4), while 29 treated with another molecular targeting agent (MTA) during the period as second-line treatment were enrolled as controls. The therapeutic efficacy of lenvatinib given as second-line treatment was retrospectively evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Median progression-free survival/median overall survival for all patients was 4.4/15.7 months and for those with Child-Pugh A was 4.7 months/not-reached. When prognosis was compared with patients who received another MTA, there was no significant difference for PFS (3.5 months, 〈 i 〉 p 〈 /i 〉 = 0.557) or OS (13.6 months, 〈 i 〉 p 〈 /i 〉 = 0.992), and also no significant differences regarding clinical background factors. mRECIST findings showed that objective response and disease control rates in patients treated with lenvatinib were 23.9% and 70.4%, respectively (CR:PR:SD:PD = 3:14:33:21), while those shown by RECIST, ver. 1.1, were 15.4% and 66.2%, respectively (CR:PR:SD:PD = 1:10:36:24). Adverse events (any grade ≥10%) were appetite loss (26.7%) (grade 1:2:3 = 2:15:10), general fatigue (21.8%) (grade 1:2:3 = 3:13:6), protein in urine (16.8%) (grade 1:2:3 = 0:4:13), and hypertension (13.9%) (grade 1:2:3 = 1:8:5). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Although lenvatinib treatment might not provide a pseudo-combination immunotherapy effect following Atez/Bev failure, lenvatinib when used as second-line treatment after Atez/Bev failure might be expected to be comparable as compared to its use as first-line treatment.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000531316
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483096-6
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  • 5
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    Relationship of Atezolizumab plus Bevacizumab Treatment with Muscle Volume Loss in Unresectable Hepatocellular Carcinoma Patients: Multicenter Analysis
    S. Karger AG ; 2023
    In:  Liver Cancer Vol. 12, No. 3 ( 2023), p. 209-217
    Details
    In: Liver Cancer, S. Karger AG, Vol. 12, No. 3 ( 2023), p. 209-217
    Abstract: 〈 b 〉 〈 i 〉 Background/Aim: 〈 /i 〉 〈 /b 〉 There is no known report regarding the relationship of atezolizumab plus bevacizumab (Atez/Bev) treatment with muscle volume loss (MVL) in unresectable hepatocellular carcinoma (u-HCC) patients. This study aimed to elucidate the clinical relationship between MVL and Atez/Bev. 〈 b 〉 〈 i 〉 Materials/Methods: 〈 /i 〉 〈 /b 〉 From September 2020 to December 2021, 229 u-HCC patients treated with Atez/Bev and with muscle volume data obtained by computed tomography at the baseline available were analyzed (median age, 74 years; males, 186 (81.2%); ECOG PS 0/1, 221 (96.5%); HCV:HBV:alcohol:others = 81:33:40:75; Child-Pugh A, 212 (92.6%); modified albumin-bilirubin (mALBI) grade 1:2a:2b = 79:60:90; BCLC 0:A:B:C = 1:24:87:117; median observation period, 6.8 months). Japan Society of Hepatology criteria were used for definition of MVL and prognostic factors were retrospectively evaluated. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Multivariate Cox-hazard analysis of prognostic factors for progression-free survival (PFS) showed elevated alpha-fetoprotein (AFP) (≥100 ng/mL) (HR 1.848, 95% CI 1.264–2.702, 〈 i 〉 p 〈 /i 〉 = 0.002), mALBI grade (≥2a) (HR 1.563, 95% CI 1.035–2.359, 〈 i 〉 p 〈 /i 〉 = 0.034), and MVL (HR 1.479, 95% CI 1.020–2.144, 〈 i 〉 p 〈 /i 〉 = 0.039) as significant factors. For overall survival (OS), significant factors included elevated AFP (≥100 ng/mL) (HR 3.564, 95% CI 1.856–6.844, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), mALBI grade (≥2a) (HR 3.451, 95% CI 1.580–7.538, 〈 i 〉 p 〈 /i 〉 = 0.002), and MVL (HR 2.119, 95% CI 1.150–3.904, 〈 i 〉 p 〈 /i 〉 = 0.016). Patients with MVL (MVL group, 〈 i 〉 n 〈 /i 〉 = 91) showed worse PFS than those without (non-MVL group, 〈 i 〉 n 〈 /i 〉 = 138) (median PFS 5.3 vs. 7.6 months, 〈 i 〉 p 〈 /i 〉 = 0.025), while the MVL group showed worse OS ( 〈 i 〉 p 〈 /i 〉 = 0.038), though neither reached the median survival time. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 MVL may be a clinical factor related to poor prognosis in patients receiving Atez/Bev treatment for u-HCC.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000527402
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
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  • 6
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    Nutritional Status Is Associated with Prognosis in Patients with Advanced Unresectable Hepatocellular Carcinoma Treated with Atezolizumab plus Bevacizumab
    S. Karger AG ; 2023
    In:  Oncology Vol. 101, No. 4 ( 2023), p. 270-282
    Details
    In: Oncology, S. Karger AG, Vol. 101, No. 4 ( 2023), p. 270-282
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 This study investigated the relationship between nutritional status, as determined by the prognostic nutritional index (PNI), and outcomes in patients with unresectable hepatocellular carcinoma (HCC) treated with atezolizumab plus bevacizumab (Atez/bev). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 The study analyzed 485 HCC patients treated with Atez/bev. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were 342 patients with a low PNI ( & #x3c;47) and 143 patients with a high PNI (≥47). The median follow-up duration was 9.4 (6.0–14.3) months. Multivariate Cox hazards analysis showed that an α-fetoprotein level ≥100 ng/mL (hazard ratio (HR), 2.217; 95% confidence interval (CI), 1.588–3.095; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), and PNI ≥47 (HR, 0.333; 95% CI, 0.212–0.525; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) were independently associated with overall survival. Multivariate analysis showed that an α-fetoprotein level ≥100 ng/mL (HR, 1.690; 95% CI, 1.316–2.170; 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001) and PNI ≥47 (HR, 0.696; 95% CI, 0.528–0.918; 〈 i 〉 p 〈 /i 〉 = 0.010) were independently associated with progression-free survival. Cumulative overall and progression-free survival rates differed significantly by PNI ( 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001 and 〈 i 〉 p 〈 /i 〉 & #x3c; 0.002, respectively). In a subgroup analysis using inverse probability weighting adjustment in patients with albumin-bilirubin grade 1 ( 〈 i 〉 n 〈 /i 〉 = 173), univariate Cox hazards analysis showed that a PNI ≥47 (HR, 0.502; 95% CI, 0.260–0.991; 〈 i 〉 p 〈 /i 〉 = 0.047) was significantly associated with overall survival. Spline curve analysis revealed that a PNI of approximately 34–48 is an appropriate cutoff for predicting good overall and progression-free survival. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 The PNI, a biomarker of nutritional status, can predict prognosis in patients with HCC treated with Atez/bev, even those who are considered to have a good prognosis due to good liver function.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000527676
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483096-6
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  • 7
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    Comparison between Atezolizumab Plus Bevacizumab and Lenvatinib for Hepatocellular Carcinoma in Patients with Child-Pugh Class B in Real-World Clinical Settings
    S. Karger AG ; 2023
    In:  Oncology Vol. 101, No. 9 ( 2023), p. 542-552
    Details
    In: Oncology, S. Karger AG, Vol. 101, No. 9 ( 2023), p. 542-552
    Abstract: 〈 b 〉 〈 i 〉 Introduction: 〈 /i 〉 〈 /b 〉 Systemic treatment is generally recommended for Child-Pugh (CP) A status patients with an unresectable hepatocellular carcinoma (uHCC). This study aimed to elucidate differences regarding therapeutic efficacy between lenvatinib (LEN), a multi-molecular target agent, and atezolizumab plus bevacizumab (Atez/Bev), a newly developed immune-combined therapeutic regimen for CP-B patients affected by uHCC. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From April 2018 to July 2022, 128 patients with uHCC treated with Atez/Bev ( 〈 i 〉 n 〈 /i 〉 = 29) or LEN ( 〈 i 〉 n 〈 /i 〉 = 99) as the initial systemic treatment were enrolled (median age 71 years; males 97; CP score 7:8:9 = 94:28:6; median albumin-bilirubin score −1.71). Therapeutic response was evaluated using RECIST, version 1.1. Clinical features and prognosis were retrospectively examined. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 There were no significant differences between the Atez/Bev and LEN groups in regard to best response (CR:PR:SD:PD = 0:5:12:7 vs. 5:22:25:20, 〈 i 〉 p 〈 /i 〉 = 0.415), progression-free survival (PFS) (median 5.0 [95% CI: 2.4–7] vs. 5.5 [95% CI: 3.4–7.9] months, 〈 i 〉 p 〈 /i 〉 = 0.332), or overall survival (OS) (5.8 [95% CI: 4.3–11] vs. 8.8 [95% CI: 6.1–12.9] months, 〈 i 〉 p 〈 /i 〉 = 0.178). Adverse events (any grade/≥ grade 3) were observed in 72.4%/17.2% ( 〈 i 〉 n 〈 /i 〉 = 21/5) of patients treated with Atez/Bev and 78.8%/25.3% ( 〈 i 〉 n 〈 /i 〉 = 78/25) of those treated with LEN ( 〈 i 〉 p 〈 /i 〉 = 0.46/0.46). 〈 b 〉 〈 i 〉 Discussion: 〈 /i 〉 〈 /b 〉 This retrospective study found no significant differences regarding PFS or OS between CP-B patients given Atez/Bev or LEN as initial systemic treatment for uHCC.
    Type of Medium: Online Resource
    ISSN: 0030-2414 , 1423-0232
    URL: Article
    DOI: 10.1159/000530028
    RVK:
    XH 3305
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2023
    detail.hit.zdb_id: 1483096-6
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  • 8
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    What Can Be Done to Solve the Unmet Clinical Need of Hepatocellular Carcinoma Patients following Lenvatinib Failure?
    S. Karger AG ; 2021
    In:  Liver Cancer Vol. 10, No. 2 ( 2021), p. 115-125
    Details
    In: Liver Cancer, S. Karger AG, Vol. 10, No. 2 ( 2021), p. 115-125
    Abstract: 〈 b 〉 〈 i 〉 Background/Aim: 〈 /i 〉 〈 /b 〉 An effective postprogression treatment of lenvatinib (LEN) against unresectable hepatocellular carcinoma (u-HCC) has not been established. We aimed to elucidate the clinical role of continuing LEN beyond progression of disease (PD). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 From March 2018 to October 2020, 99 u-HCC patients, in whom PD was confirmed (male:female = 78:21, median age 72 years, Child-Pugh A = 99, Barcelona Clinic Liver Cancer stage A:B:C = 2:43:54, LEN as first-line = 55), were enrolled (stopped LEN at PD [A group], 〈 i 〉 n 〈 /i 〉 = 26; continued LEN beyond PD [B group], 〈 i 〉 n 〈 /i 〉 = 73). Radiological response was evaluated with RECIST 1.1. Clinical features and prognostic factors for overall survival (OS) were retrospectively investigated using inverse probability weighting (IPW) calculated by propensity score. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 Median time to progression, best response, and modified albumin-bilirubin grade (mALBI) at both baseline and PD did not show significant difference between the groups. Postprogression treatment in the A group was best supportive care in 17, sorafenib in 4, regorafenib in 3, ramucirumab in 1, and hepatic arterial infusion chemotherapy in 1. After adjusting with IPW, the B group showed better prognosis in regard to OS after PD and OS after introducing LEN than the A group (10.8/19.6 vs. 5.8/11.2 months, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001, respectively). In IPW-adjusted Cox hazard multivariate analysis, significant prognostic factors for OS after PD were mALBI 2b/3 at PD (HR 1.983, 〈 i 〉 p 〈 /i 〉 = 0.021), decline of Eastern Cooperative Oncology Group performance status (ECOG PS) from baseline at PD (HR 3.180, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), elevated alpha-fetoprotein (≥100 ng/mL) at introducing LEN (HR 2.511, 〈 i 〉 p 〈 /i 〉 = 0.004), appearance of new extrahepatic metastasis (HR 2.396, 〈 i 〉 p 〈 /i 〉 = 0.006), positive for hand-foot skin reaction (HFSR) before PD (any grade) (HR 0.292, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001), and continuing LEN beyond PD (HR 0.297, 〈 i 〉 p 〈 /i 〉 & #x3c; 0.001). 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 When ECOG PS and hepatic reserve function permit, continuing LEN treatment beyond PD, especially in u-HCC patients showed HFSR during LEN treatment, might be a good therapeutic option, at least until a more effective drug as a postprogression treatment after LEN failure is developed.
    Type of Medium: Online Resource
    ISSN: 2235-1795 , 1664-5553
    URL: Article
    DOI: 10.1159/000513355
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2021
    detail.hit.zdb_id: 2666925-0
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