Lenvatinib prolongs the progression‑free survival time of patients with intermediate‑stage hepatocellular carcinoma refractory to transarterial chemoembolization: A multicenter cohort study using data mining analysis

Shimose,Shigeo; Kawaguchi,Takumi; Tanaka,Masatoshi; Iwamoto,Hideki; Miyazaki,Ken; Moriyama,Etsuko; Suzuki,Hiroyuki; Niizeki,Takashi; Shirono,Tomotake; Nakano,Masahito; Suga,Hideya; Yamaguchi,Taizo; Yokokura,Yoshinori; Noguchi,Kazunori; Koga,Hironori; Torimura,Takuji

doi:10.3892/ol.2020.11758

Lenvatinib prolongs the progression‑free survival time of patients with intermediate‑stage hepatocellular carcinoma refractory to transarterial chemoembolization: A multicenter cohort study using data mining analysis

Authors:
- Shigeo Shimose
- Takumi Kawaguchi
- Masatoshi Tanaka
- Hideki Iwamoto
- Ken Miyazaki
- Etsuko Moriyama
- Hiroyuki Suzuki
- Takashi Niizeki
- Tomotake Shirono
- Masahito Nakano
- Hideya Suga
- Taizo Yamaguchi
- Yoshinori Yokokura
- Kazunori Noguchi
- Hironori Koga
- Takuji Torimura
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Affiliations: Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830‑0011, Japan, Department of Gastroenterology and Hepatology, Yokokura Hospital, Miyama, Fukuoka 839‑0295, Japan, Department of Gastroenterology and Hepatology, Yanagawa Hospital, Yanagawa, Fukuoka 832‑0077, Japan, Department of Gastroenterology and Hepatology, Iwamoto Internal Medical Clinic, Kitakyushu, Fukuoka 802‑0832, Japan, Department of Gastroenterology and Hepatology, Omuta City Hospital, Omuta, Fukuoka 836‑8567, Japan
Published online on: June 19, 2020 https://doi.org/10.3892/ol.2020.11758
Pages: 2257-2265
Copyright: © Shimose et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Tyrosine kinase inhibitors are considered for use in patients with hepatocellular carcinoma (HCC) refractory to transarterial chemoembolization (TACE). The aim of the present retrospective study was to identify factors associated with progression‑free survival (PFS) and to evaluate the indications for lenvatinib treatment in patients with intermediate‑stage HCC refractory to TACE using a data‑mining analysis. A total of 171 patients with intermediate‑stage HCC refractory to TACE were included. All patients were classified into three groups according to their HCC treatment: Lenvatinib (n=45), sorafenib (n=53) and TACE (n=73) groups. PFS time was calculated using the Kaplan‑Meier method and analyzed using a log‑rank test. Factors associated with PFS time were evaluated using multivariate and decision‑tree analyses. The median PFS time was 5.8, 3.2 and 2.4 months in the lenvatinib, sorafenib and TACE groups, respectively (P<0.001). In the Cox regression analysis, lenvatinib treatment and being within the up‑to‑seven criteria were identified as independent factors for PFS (lenvatinib, P<0.0001; within up‑to‑seven, P=0.001). The decision‑tree analysis revealed that patients beyond the up‑to‑seven criteria, treated with lenvatinib and with albumin‑bilirubin (ALBI) grade 1 had a longer PFS time (245.2±107.9 days) than patients beyond the up‑to‑seven criteria, treated with lenvatinib and with ALBI grade 2 (147.1±78.6 days). Additionally, lenvatinib was independently associated with longer PFS time in patients with intermediate‑stage HCC refractory to TACE. Therefore, lenvatinib may be recommended for patients who have intermediate‑stage HCC refractory to TACE, ALBI grade 1 and who are within the up‑to‑seven criteria.

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