Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study.
| Title: | Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study. |
|---|---|
| Authors: | Palmer, Mathias E.1 (AUTHOR) palmer.mathias@mayo.edu, Gile, Jennifer J.2 (AUTHOR) gile.jennifer@mayo.edu, Storandt, Michael H.1 (AUTHOR) storandt.michael@mayo.edu, Jin, Zhaohui2 (AUTHOR) jin.zhaohui@mayo.edu, Zemla, Tyler J.3 (AUTHOR) zemla.tyler@mayo.edu, Tran, Nguyen H.2 (AUTHOR) tran.nguyen@mayo.edu, Mahipal, Amit2,4 (AUTHOR) amit.mahipal@uhhospitals.org |
| Source: | Cancers. Oct2023, Vol. 15 Issue 19, p4867. 12p. |
| Subject Terms: | *THERAPEUTIC use of antineoplastic agents, *DRUG efficacy, *DISEASE progression, *RESEARCH, *TIME, *MULTIVARIATE analysis, *RETROSPECTIVE studies, *RACE, *METASTASIS, *SEX distribution, *RESEARCH funding, *PROGRESSION-free survival, *BODY mass index, *HEPATOCELLULAR carcinoma, *IMMUNOTHERAPY, *OVERALL survival |
| Abstract: | Simple Summary: Immunotherapy with atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab has recently become the preferred first-line treatment for advanced hepatocellular carcinoma (HCC). Lenvatinib was initially approved as a first-line treatment, but little is known about its effectiveness following immunotherapy. The aim of our retrospective study was to characterize the clinical outcomes with lenvatinib following immunotherapy treatment. In our cohort of 53 patients, the median progression free survival was 3.7 months, and the median overall survival was 12.8 months from lenvatinib initiation. Multivariate analysis demonstrated race, gender, and Child Pugh Class as significant predictors of survival outcomes and BMI as well as distant metastasis as predictors of progression free survival. This study supports the efficacy of lenvatinib following immunotherapy and validates the use of lenvatinib as a second-line therapy following progression on immunotherapy in patients with advanced HCC. Background: Lenvatinib, a multikinase inhibitor, is an FDA-approved treatment for advanced hepatocellular carcinoma (HCC) in the first-line setting. Recent trial data have established atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab as preferred first-line treatment options for advanced HCC. The role of lenvatinib following progression on immunotherapy in patients with advanced HCC remains unclear. Methods: We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010 and 2021 at the Mayo Clinic in Minnesota, Arizona, and Florida who received immunotherapy followed by lenvatinib. Median overall survival and progression-free survival analyses were performed using the Kaplan–Meier method, and responses were determined using RECIST 1.1. Adverse events were determined using CTCAE v 4.0. Results: We identified 53 patients with advanced HCC who received lenvatinib following progression on immunotherapy. Forty five (85%) patients had a Child Pugh class A at diagnosis, while 30 (58%) patients were still Child Pugh A at time of lenvatinib initiation. Lenvatinib was administered as a second-line treatment in 85% of the patients. The median PFS was 3.7 months (95% CI: 3.2–6.6), and the median OS from the time of lenvatinib initiation was 12.8 months (95% CI: 6.7–19.5). In patients with Child Pugh class A, the median OS and PFS was 14 and 5.2 months, respectively. Race, gender, and Child Pugh class was associated with OS on multivariate analysis. Discussion: Our study, using real-world data, suggests that patients benefit from treatment with lenvatinib following progression on immunotherapy in advanced HCC. The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown, and these results need to be validated in a clinical trial. [ABSTRACT FROM AUTHOR] |
| Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Academic Search Complete |
| Full text is not displayed to guests. | Login for full access. |
| FullText | Links: – Type: pdflink Text: Availability: 1 CustomLinks: – Url: https://resolver.ebsco.com/c/xy5jbn/result?sid=EBSCO:a9h&genre=article&issn=20726694&ISBN=&volume=15&issue=19&date=20231001&spage=4867&pages=4867-4878&title=Cancers&atitle=Outcomes%20of%20Patients%20with%20Advanced%20Hepatocellular%20Carcinoma%20Receiving%20Lenvatinib%20following%20Immunotherapy%3A%20A%20Real%20World%20Evidence%20Study.&aulast=Palmer%2C%20Mathias%20E.&id=DOI:10.3390/cancers15194867 Name: Full Text Finder (for New FTF UI) (s8985755) Category: fullText Text: Find It @ SCU Libraries MouseOverText: Find It @ SCU Libraries |
|---|---|
| Header | DbId: a9h DbLabel: Academic Search Complete An: 172983829 AccessLevel: 6 PubType: Academic Journal PubTypeId: academicJournal PreciseRelevancyScore: 0 |
| IllustrationInfo | |
| Items | – Name: Title Label: Title Group: Ti Data: Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Palmer%2C+Mathias+E%2E%22">Palmer, Mathias E.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> palmer.mathias@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Gile%2C+Jennifer+J%2E%22">Gile, Jennifer J.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<i> gile.jennifer@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Storandt%2C+Michael+H%2E%22">Storandt, Michael H.</searchLink><relatesTo>1</relatesTo> (AUTHOR)<i> storandt.michael@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Jin%2C+Zhaohui%22">Jin, Zhaohui</searchLink><relatesTo>2</relatesTo> (AUTHOR)<i> jin.zhaohui@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Zemla%2C+Tyler+J%2E%22">Zemla, Tyler J.</searchLink><relatesTo>3</relatesTo> (AUTHOR)<i> zemla.tyler@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Tran%2C+Nguyen+H%2E%22">Tran, Nguyen H.</searchLink><relatesTo>2</relatesTo> (AUTHOR)<i> tran.nguyen@mayo.edu</i><br /><searchLink fieldCode="AR" term="%22Mahipal%2C+Amit%22">Mahipal, Amit</searchLink><relatesTo>2,4</relatesTo> (AUTHOR)<i> amit.mahipal@uhhospitals.org</i> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22Cancers%22">Cancers</searchLink>. Oct2023, Vol. 15 Issue 19, p4867. 12p. – Name: Subject Label: Subject Terms Group: Su Data: *<searchLink fieldCode="DE" term="%22THERAPEUTIC+use+of+antineoplastic+agents%22">THERAPEUTIC use of antineoplastic agents</searchLink><br />*<searchLink fieldCode="DE" term="%22DRUG+efficacy%22">DRUG efficacy</searchLink><br />*<searchLink fieldCode="DE" term="%22DISEASE+progression%22">DISEASE progression</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH%22">RESEARCH</searchLink><br />*<searchLink fieldCode="DE" term="%22TIME%22">TIME</searchLink><br />*<searchLink fieldCode="DE" term="%22MULTIVARIATE+analysis%22">MULTIVARIATE analysis</searchLink><br />*<searchLink fieldCode="DE" term="%22RETROSPECTIVE+studies%22">RETROSPECTIVE studies</searchLink><br />*<searchLink fieldCode="DE" term="%22RACE%22">RACE</searchLink><br />*<searchLink fieldCode="DE" term="%22METASTASIS%22">METASTASIS</searchLink><br />*<searchLink fieldCode="DE" term="%22SEX+distribution%22">SEX distribution</searchLink><br />*<searchLink fieldCode="DE" term="%22RESEARCH+funding%22">RESEARCH funding</searchLink><br />*<searchLink fieldCode="DE" term="%22PROGRESSION-free+survival%22">PROGRESSION-free survival</searchLink><br />*<searchLink fieldCode="DE" term="%22BODY+mass+index%22">BODY mass index</searchLink><br />*<searchLink fieldCode="DE" term="%22HEPATOCELLULAR+carcinoma%22">HEPATOCELLULAR carcinoma</searchLink><br />*<searchLink fieldCode="DE" term="%22IMMUNOTHERAPY%22">IMMUNOTHERAPY</searchLink><br />*<searchLink fieldCode="DE" term="%22OVERALL+survival%22">OVERALL survival</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Simple Summary: Immunotherapy with atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab has recently become the preferred first-line treatment for advanced hepatocellular carcinoma (HCC). Lenvatinib was initially approved as a first-line treatment, but little is known about its effectiveness following immunotherapy. The aim of our retrospective study was to characterize the clinical outcomes with lenvatinib following immunotherapy treatment. In our cohort of 53 patients, the median progression free survival was 3.7 months, and the median overall survival was 12.8 months from lenvatinib initiation. Multivariate analysis demonstrated race, gender, and Child Pugh Class as significant predictors of survival outcomes and BMI as well as distant metastasis as predictors of progression free survival. This study supports the efficacy of lenvatinib following immunotherapy and validates the use of lenvatinib as a second-line therapy following progression on immunotherapy in patients with advanced HCC. Background: Lenvatinib, a multikinase inhibitor, is an FDA-approved treatment for advanced hepatocellular carcinoma (HCC) in the first-line setting. Recent trial data have established atezolizumab plus bevacizumab as well as tremelimumab plus durvalumab as preferred first-line treatment options for advanced HCC. The role of lenvatinib following progression on immunotherapy in patients with advanced HCC remains unclear. Methods: We conducted a multicentric, retrospective analysis of patients with advanced HCC diagnosed between 2010 and 2021 at the Mayo Clinic in Minnesota, Arizona, and Florida who received immunotherapy followed by lenvatinib. Median overall survival and progression-free survival analyses were performed using the Kaplan–Meier method, and responses were determined using RECIST 1.1. Adverse events were determined using CTCAE v 4.0. Results: We identified 53 patients with advanced HCC who received lenvatinib following progression on immunotherapy. Forty five (85%) patients had a Child Pugh class A at diagnosis, while 30 (58%) patients were still Child Pugh A at time of lenvatinib initiation. Lenvatinib was administered as a second-line treatment in 85% of the patients. The median PFS was 3.7 months (95% CI: 3.2–6.6), and the median OS from the time of lenvatinib initiation was 12.8 months (95% CI: 6.7–19.5). In patients with Child Pugh class A, the median OS and PFS was 14 and 5.2 months, respectively. Race, gender, and Child Pugh class was associated with OS on multivariate analysis. Discussion: Our study, using real-world data, suggests that patients benefit from treatment with lenvatinib following progression on immunotherapy in advanced HCC. The optimal sequencing of therapy for patients with advanced HCC following progression on immunotherapy remains unknown, and these results need to be validated in a clinical trial. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
| PLink | https://login.libproxy.scu.edu/login?url=https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=a9h&AN=172983829 |
| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.3390/cancers15194867 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 12 StartPage: 4867 Subjects: – SubjectFull: THERAPEUTIC use of antineoplastic agents Type: general – SubjectFull: DRUG efficacy Type: general – SubjectFull: DISEASE progression Type: general – SubjectFull: RESEARCH Type: general – SubjectFull: TIME Type: general – SubjectFull: MULTIVARIATE analysis Type: general – SubjectFull: RETROSPECTIVE studies Type: general – SubjectFull: RACE Type: general – SubjectFull: METASTASIS Type: general – SubjectFull: SEX distribution Type: general – SubjectFull: RESEARCH funding Type: general – SubjectFull: PROGRESSION-free survival Type: general – SubjectFull: BODY mass index Type: general – SubjectFull: HEPATOCELLULAR carcinoma Type: general – SubjectFull: IMMUNOTHERAPY Type: general – SubjectFull: OVERALL survival Type: general Titles: – TitleFull: Outcomes of Patients with Advanced Hepatocellular Carcinoma Receiving Lenvatinib following Immunotherapy: A Real World Evidence Study. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Palmer, Mathias E. – PersonEntity: Name: NameFull: Gile, Jennifer J. – PersonEntity: Name: NameFull: Storandt, Michael H. – PersonEntity: Name: NameFull: Jin, Zhaohui – PersonEntity: Name: NameFull: Zemla, Tyler J. – PersonEntity: Name: NameFull: Tran, Nguyen H. – PersonEntity: Name: NameFull: Mahipal, Amit IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 10 Text: Oct2023 Type: published Y: 2023 Identifiers: – Type: issn-print Value: 20726694 Numbering: – Type: volume Value: 15 – Type: issue Value: 19 Titles: – TitleFull: Cancers Type: main |
| ResultId | 1 |