論文

国際誌
2021年12月15日

Prospect of lenvatinib for unresectable hepatocellular carcinoma in the new era of systemic chemotherapy.

World journal of gastrointestinal oncology
  • Takuya Sho
  • Kenichi Morikawa
  • Akinori Kubo
  • Yoshimasa Tokuchi
  • Takashi Kitagataya
  • Ren Yamada
  • Taku Shigesawa
  • Mugumi Kimura
  • Masato Nakai
  • Goki Suda
  • Mitsuteru Natsuizaka
  • Koji Ogawa
  • Naoya Sakamoto
  • 全て表示

13
12
開始ページ
2076
終了ページ
2087
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.4251/wjgo.v13.i12.2076

The phase III clinical trial of the novel molecular targeted agent (MTA) lenvatinib for patients with advanced hepatocellular carcinoma (HCC) (REFLECT trial) found that lenvatinib was non-inferior to sorafenib in overall survival. Recently, the efficacy of multiple MTAs, including lenvatinib, in practice has been reported, and therapeutic strategies for Barcelona Clinic Liver Cancer (BCLC) intermediate stage HCC are undergoing major changes. Based on these results, lenvatinib could be recommended for patients with transcatheter arterial chemoembolization (TACE)-refractory, ALBI grade 1, within the up-to-seven criteria in the BCLC intermediate stage. Lenvatinib provides a more favorable outcome than TACE, even in cases with large or multinodular HCC beyond the up-to-seven criteria with Child-Pugh grade A. When patients meet the definitions of TACE-refractory or TACE-unsuitable, switching to systemic chemotherapy, including lenvatinib, is for favorable for preserving liver function. If initial treatment, including MTA, has a significant therapeutic effect and downstaging of HCC is obtained, additional TACE or surgical resection should be considered. Lenvatinib also has a therapeutic effect for poorly differentiated type and non-simple nodular type HCC thanks to the survival-prolonging effect of this drug. Furthermore, a significant therapeutic effect is expected in tumors with more than 50% liver involvement or main portal vein invasion, which have traditionally been considered to have a poor prognosis in patients. This suggests that at the start of lenvatinib treatment, HCC patients with ALBI grade 1 may be able to maintain liver functional reserve.

リンク情報
DOI
https://doi.org/10.4251/wjgo.v13.i12.2076
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/35070043
PubMed Central
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8713309
ID情報
  • DOI : 10.4251/wjgo.v13.i12.2076
  • PubMed ID : 35070043
  • PubMed Central 記事ID : PMC8713309

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