PMID- 35978602 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20220819 IS - 2235-1795 (Print) IS - 1664-5553 (Electronic) IS - 1664-5553 (Linking) VI - 11 IP - 4 DP - 2022 Jul TI - Objective Response by mRECIST to Initial Lenvatinib Therapy Is an Independent Factor Contributing to Deep Response in Hepatocellular Carcinoma Treated with Lenvatinib-Transcatheter Arterial Chemoembolization Sequential Therapy. PG - 383-396 LID - 10.1159/000522424 [doi] AB - OBJECTIVE: There is limited information regarding the benefits of Lenvatinib-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy for unresectable hepatocellular carcinoma (u-HCC). We compared the efficacy and safety of LEN-TACE sequential therapy to LEN monotherapy and investigated the factors contributing to the LEN-TACE sequential therapy deep response. METHODS: We enrolled a multicenter cohort of 247 patients with u-HCC treated with LEN between 2018 and 2020. Propensity score matching identified 63 matching pairs of patients with well-balanced characteristics. We retrospectively compared the clinical outcomes, including overall survival (OS), progression-free survival (PFS), and incidence of adverse events (AEs), between the LEN-TACE and LEN monotherapy groups. Additionally, we evaluated the tumor response, change in albumin-bilirubin (ALBI) score, factors affecting PFS and OS, and independent predictors contributing to the LEN-TACE sequential therapy deep response. In this study, at eight weeks after resumption of LEN after initial TACE, "deep response" was defined as achieving complete response or partial response (PR) on modified Response Evaluation Criteria in Solid Tumors (mRECIST), and at least a 30% decrease in the sum of diameters of target lesions, taking the baseline sum diameters as the reference. RESULTS: The OS and PFS in the LEN-TACE group were significantly higher than those in the LEN monotherapy group (p = 0.002 and p = 0.037, respectively). The incidence of AEs related to LEN was not significantly different between the two groups. In LEN-TACE sequential therapy, the objective response rate was 61.9%, and the disease control rate was 74.6%, according to the mRECIST criteria. No significant change in the ALBI score was observed during sequential LEN-TACE therapy. Multivariable analyses revealed that deep response was independently associated with the outcome of the initial response to LEN by mRECIST: PR (odds ratio: 5.176, 95% confidence interval: 1.528-17.537, p < 0.001). CONCLUSIONS: LEN-TACE sequential therapy may provide more clinical benefits than LEN monotherapy in u-HCC patients who responded to initial LEN treatment. Objective response according to mRECIST to initial LEN is an independent factor contributing to LEN-TACE sequential therapy deep response. CI - Copyright (c) 2022 by The Author(s). Published by S. Karger AG, Basel. FAU - Kuroda, Hidekatsu AU - Kuroda H AD - Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan. FAU - Oikawa, Takayoshi AU - Oikawa T AD - Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan. FAU - Ninomiya, Masashi AU - Ninomiya M AD - Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. FAU - Fujita, Masashi AU - Fujita M AD - Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan. FAU - Abe, Kazumichi AU - Abe K AD - Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan. FAU - Okumoto, Kazuo AU - Okumoto K AD - Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. FAU - Katsumi, Tomohiro AU - Katsumi T AD - Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. FAU - Sato, Wataru AU - Sato W AD - Department of Gastroenterology, Graduate School of Medicine, Akita University, Akita, Japan. FAU - Igarashi, Go AU - Igarashi G AD - Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Iino, Chikara AU - Iino C AD - Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Endo, Tetsu AU - Endo T AD - Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Tanabe, Nobukazu AU - Tanabe N AD - Department of Gastroenterology, National Hospital Organisation Sendai Medical Center, Sendai, Japan. FAU - Numao, Hiroshi AU - Numao H AD - Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan. FAU - Fukuda, Shinsaku AU - Fukuda S AD - Department of Gastroenterology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan. FAU - Iijima, Katsunori AU - Iijima K AD - Department of Gastroenterology, Graduate School of Medicine, Akita University, Akita, Japan. FAU - Masamune, Atsushi AU - Masamune A AD - Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai, Japan. FAU - Ohira, Hiromasa AU - Ohira H AD - Department of Gastroenterology, Fukushima Medical University School of Medicine, Fukushima, Japan. FAU - Ueno, Yoshiyuki AU - Ueno Y AD - Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan. FAU - Takikawa, Yasuhiro AU - Takikawa Y AD - Division of Hepatology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan. LA - eng PT - Journal Article DEP - 20220215 PL - Switzerland TA - Liver Cancer JT - Liver cancer JID - 101597993 PMC - PMC9294936 OTO - NOTNLM OT - Hepatocellular carcinoma OT - Lenvatinib-transcatheter arterial chemoembolization sequential therapy OT - Modified RECIST OT - Objective response EDAT- 2022/08/19 06:00 MHDA- 2022/08/19 06:01 PMCR- 2022/02/15 CRDT- 2022/08/18 02:03 PHST- 2021/10/18 00:00 [received] PHST- 2022/02/02 00:00 [accepted] PHST- 2022/08/18 02:03 [entrez] PHST- 2022/08/19 06:00 [pubmed] PHST- 2022/08/19 06:01 [medline] PHST- 2022/02/15 00:00 [pmc-release] AID - lic-0011-0383 [pii] AID - 10.1159/000522424 [doi] PST - epublish SO - Liver Cancer. 2022 Feb 15;11(4):383-396. doi: 10.1159/000522424. eCollection 2022 Jul.