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GIUSEPPE CABIBBO

Adverse events as potential predictive factors of activity in patients with advanced hepatocellular carcinoma treated with lenvatinib

  • Autori: Rapposelli I.G.; Tada T.; Shimose S.; Burgio V.; Kumada T.; Iwamoto H.; Hiraoka A.; Niizeki T.; Atsukawa M.; Koga H.; Hirooka M.; Torimura T.; Iavarone M.; Tortora R.; Campani C.; Lonardi S.; Tamburini E.; Piscaglia F.; Masi G.; Cabibbo G.; Giuseppe Foschi F.; Silletta M.; Tsuji K.; Ishikawa T.; Takaguchi K.; Kariyama K.; Itobayashi E.; Tajiri K.; Shimada N.; Shibata H.; Ochi H.; Yasuda S.; Toyoda H.; Fukunishi S.; Ohama H.; Kawata K.; Tani J.; Nakamura S.; Nouso K.; Tsutsui A.; Nagano T.; Tanaka T.; Itokawa N.; Okubo T.; Arai T.; Imai M.; Joko K.; Koizumi Y.; Hiasa Y.; Rimini M.; Ratti F.; Aldrighetti L.; Cascinu S.; Casadei-Gardini A.
  • Anno di pubblicazione: 2021
  • Tipologia: Articolo in rivista
  • OA Link: http://hdl.handle.net/10447/544146

Abstract

Background and Aim: Lenvatinib is a standard of care option in first-line therapy of advanced hepatocellular carcinoma (HCC). In the present study, we aim to identify, in patients with HCC treated with lenvatinib, a possible association between occurrence and grading of adverse events (AEs) and outcome. Methods: We performed a retrospective analysis of 606 Japanese and Italian patients treated with lenvatinib in first-line setting and investigated the possible correlation between the onset of AEs, toxicity grade (G) and outcome measures such as overall survival (OS) and progression-free survival (PFS). Results: The appearance of arterial hypertension G â‰¥ 2 independently predicted prolonged OS [hazard ratio (HR) 0.66, 95% confidence interval (CI) 0.46–0.93, P =.0188], whereas decreased appetite G â‰¥ 2 independently predicted decreased OS (HR 1.70, 95% CI 1.25–2.32, P =.0007) by multivariate analysis. Appearance of hand-foot skin reaction independently predicted prolonged PFS (HR 0.72, 95% CI 0.56–0.93, P =.0149), whereas decreased appetite G â‰¥ 2 predicted decreased PFS (HR 1.36, 95% CI 1.04–1.77, P =.0277). Conclusions: Our main findings are that the occurrence of arterial hypertension G â‰¥ 2 is a predictor of longer survival, whereas decreased appetite G â‰¥ 2 predicts for a poor prognosis. A careful management of AEs under lenvatinib treatment for HCC is required, to improve patients’ quality of life, minimize the need for treatment discontinuation and achieve optimal outcome.