Clinical Outcomes with Multikinase Inhibitors after Progression on First-Line Atezolizumab plus Bevacizumab in Patients with Advanced Hepatocellular Carcinoma: A Multinational Multicenter Retrospective Study
| Autor: | Min-Hee Ryu, Sook Ryun Park, Baek-Yeol Ryoo, David Wai-Meng Tai, Han Chu Lee, Danbi Lee, Young-Suk Lim, Kang Mo Kim, Stephen L. Chan, Joycelyn Lee, Changhoon Yoo, Ju Hyun Shim, J.H. Kim |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Sorafenib
Oncology atezolizumab medicine.medical_specialty Bevacizumab Disease lenvatinib bevacizumab lcsh:RC254-282 Multikinase inhibitor 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Atezolizumab Internal medicine medicine Original Paper Hepatology business.industry Retrospective cohort study hepatocellular carcinoma medicine.disease lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens chemistry 030220 oncology & carcinogenesis Hepatocellular carcinoma 030211 gastroenterology & hepatology sorafenib Lenvatinib business multikinase inhibitor medicine.drug |
| Zdroj: | Liver Cancer, Vol 10, Iss 2, Pp 107-114 (2021) Liver Cancer |
| ISSN: | 1664-5553 2235-1795 |
| Popis: | Introduction: Atezolizumab-bevacizumab is the new standard of care for first-line treatment of advanced hepatocellular carcinoma (HCC). However, the optimal sequence of therapy after disease progression on atezolizumab-bevacizumab is unclear. Methods: This multinational, multicenter, and retrospective study assessed clinical outcomes of patients with advanced HCC who received subsequent systemic therapy after progression on atezolizumab-bevacizumab between July 2016 and April 2019. Results: Among 71 patients treated with atezolizumab-bevacizumab, a total of 49 patients who received subsequent systemic therapy were included in this analysis; the median age was 60 years (range, 37–80) and 73.5% were male. All patients were classified as Child-Pugh A and Barcelona-Clinic Liver Cancer stage C. Multikinase inhibitors (MKIs), including sorafenib (n = 29), lenvatinib (n = 19), and cabozantinib (n = 1), were used as second-line therapy for all patients. The objective response rate and disease control rate were 6.1 and 63.3%, respectively, in all patients. With a median follow-up duration of 11.0 months, median progression-free survival (PFS) and overall survival (OS) were 3.4 months (95% confidence interval [CI] 1.8–4.9) and 14.7 months (95% CI 8.1–21.2) in all patients. Median PFS with lenvatinib was significantly longer than that with sorafenib (6.1 vs. 2.5 months; p = 0.004), although there was no significant difference in median OS (16.6 vs. 11.2 months; p = 0.347). Treatment-related adverse events (TRAEs) of any grade and grade 3 occurred in 42 (85.7) and 8 (16.3%) of patients. Common TRAEs included hand-foot syndrome (n = 26, 53.1%), fatigue (n = 14, 28.6%), hypertension (n = 14, 28.6%), and diarrhea (n = 12, 24.5%). Conclusion: Second-line treatment with MKIs, mostly sorafenib and lenvatinib, showed comparable efficacy and manageable toxicities in patients with advanced HCC after disease progression on atezolizumab-bevacizumab. |
| Databáze: | OpenAIRE |
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