PMID- 36006547
OWN - NLM
STAT- MEDLINE
DCOM- 20221004
LR  - 20221019
IS  - 1936-0541 (Electronic)
IS  - 1936-0533 (Print)
IS  - 1936-0533 (Linking)
VI  - 16
IP  - 5
DP  - 2022 Oct
TI  - Lenvatinib for the treatment of hepatocellular carcinoma-a real-world multicenter 
      Australian cohort study.
PG  - 1170-1178
LID - 10.1007/s12072-022-10398-5 [doi]
AB  - INTRODUCTION: Hepatocellular carcinoma (HCC) is a serious complication of chronic 
      liver disease. Lenvatinib is an oral multikinase inhibitor registered to treat 
      advanced HCC. This study evaluates the real-world experience with lenvatinib in 
      Australia. METHODS: We conducted a retrospective cohort study of patients treated 
      with lenvatinib for advanced HCC between July 2018 and November 2020 at 11 
      Australian tertiary care hospitals. Baseline demographic data, tumor 
      characteristics, lenvatinib dosing, adverse events (AEs) and clinical outcomes 
      were collected. Overall survival (OS) was the primary outcome. Progression free 
      survival (PFS) and AEs were secondary outcomes. RESULTS: A total of 155 patients 
      were included and were predominantly male (90.7%) with a median age of 65 years 
      (interquartile range [IQR]: 59-75). The main causes of chronic liver disease were 
      hepatitis C infection (40.0%) and alcohol-related liver disease (34.2). Median OS 
      and PFS were 7.7 (95% confidence interval [CI]: 5.8-14.0) and 5.3 months (95% CI: 
      2.8-9.2) respectively. Multivariate predictors of mortality were the need for 
      dose reduction due to AEs (Hazard ratio [HR] 0.41, p < 0.01), new or worsening 
      hypertension (HR 0.42, p < 0.01), diarrhoea (HR 0.47, p = 0.04) and more advanced 
      BCLC stage (HR 2.50, p = 0.04). Multivariable predictors of disease progression 
      were higher Child-Pugh score (HR 1.25, p = 0.04), the need for a dose reduction 
      (HR 0.45, p < 0.01) and age (HR 0.96, p < 0.001). AEs occurred in 83.9% of 
      patients with most being mild (71.6%). CONCLUSIONS: Lenvatinib remains safe and 
      effective in real-world use. Treatment emergent diarrhoea and hypertension, and 
      the need for dose reduction appear to predict better OS.
CI  - (c) 2022. The Author(s).
FAU - Patwala, Kurvi
AU  - Patwala K
AUID- ORCID: 0000-0002-9235-146X
AD  - Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, VIC, 
      3168, Australia. kurvipatwala@gmail.com.
FAU - Prince, David Stephen
AU  - Prince DS
AD  - AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, 50 
      Missenden Road, Camperdown, NSW, 2050, Australia. David.Prince@health.nsw.gov.au.
AD  - Department of Gastroenterology, Liverpool Hospital, 75 Elizabeth Street, 
      Liverpool, NSW, 2170, Australia. David.Prince@health.nsw.gov.au.
FAU - Celermajer, Yael
AU  - Celermajer Y
AD  - AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, 50 
      Missenden Road, Camperdown, NSW, 2050, Australia.
FAU - Alam, Waafiqa
AU  - Alam W
AD  - Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, VIC, 
      3168, Australia.
FAU - Paul, Eldho
AU  - Paul E
AD  - Department of Medicine, Monash University, Wellington Road, Clayton, VIC, 3800, 
      Australia.
FAU - Strasser, Simone Irene
AU  - Strasser SI
AD  - AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, 50 
      Missenden Road, Camperdown, NSW, 2050, Australia.
FAU - McCaughan, Geoffrey William
AU  - McCaughan GW
AD  - AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, 50 
      Missenden Road, Camperdown, NSW, 2050, Australia.
FAU - Gow, Paul
AU  - Gow P
AD  - Department of Gastroenterology and Liver Transplant, Austin Health, 145 Studley 
      Road, Heidelberg, VIC, 3084, Australia.
FAU - Sood, Siddharth
AU  - Sood S
AD  - Department of Gastroenterology, Royal Melbourne Hospital, 300 Grattan Street, 
      Parkville, VIC, 3050, Australia.
FAU - Murphy, Elise
AU  - Murphy E
AD  - Department of Gastroenterology, Royal Melbourne Hospital, 300 Grattan Street, 
      Parkville, VIC, 3050, Australia.
FAU - Roberts, Stuart
AU  - Roberts S
AD  - Department of Medicine, Monash University, Wellington Road, Clayton, VIC, 3800, 
      Australia.
AD  - Department of Gastroenterology, Alfred Health, 55 Commercial Road, Melbourne, 
      VIC, 3004, Australia.
FAU - Freeman, Elliot
AU  - Freeman E
AD  - Department of Gastroenterology, Alfred Health, 55 Commercial Road, Melbourne, 
      VIC, 3004, Australia.
FAU - Stratton, Elizabeth
AU  - Stratton E
AD  - Department of Gastroenterology, Liverpool Hospital, 75 Elizabeth Street, 
      Liverpool, NSW, 2170, Australia.
FAU - Davison, Scott Anthony
AU  - Davison SA
AD  - Department of Gastroenterology, Liverpool Hospital, 75 Elizabeth Street, 
      Liverpool, NSW, 2170, Australia.
FAU - Levy, Miriam Tania
AU  - Levy MT
AD  - Department of Gastroenterology, Liverpool Hospital, 75 Elizabeth Street, 
      Liverpool, NSW, 2170, Australia.
FAU - Clark-Dickson, McCawley
AU  - Clark-Dickson M
AD  - Department of Gastroenterology, Royal North Shore Hospital, Reserve Road, St 
      Leonard's, NSW, 2065, Australia.
FAU - Nguyen, Vi
AU  - Nguyen V
AD  - Department of Gastroenterology, Royal North Shore Hospital, Reserve Road, St 
      Leonard's, NSW, 2065, Australia.
FAU - Bell, Sally
AU  - Bell S
AD  - Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, VIC, 
      3168, Australia.
FAU - Nicoll, Amanda
AU  - Nicoll A
AD  - Department of Gastroenterology, Eastern Health, 8 Arnold Street, Box Hill, VIC, 
      3128, Australia.
FAU - Bloom, Ashley
AU  - Bloom A
AD  - Department of Gastroenterology, Eastern Health, 8 Arnold Street, Box Hill, VIC, 
      3128, Australia.
FAU - Lee, Alice Unah
AU  - Lee AU
AD  - Department of Gastroenterology, Concord Repatriation General Hospital, Hospital 
      Road, Concord, NSW, 2139, Australia.
FAU - Ryan, Marno
AU  - Ryan M
AD  - Department of Gastroenterology, St Vincent's Hospital, 41 Victoria Parade, 
      Fitzroy, VIC, 3065, Australia.
FAU - Howell, Jessica
AU  - Howell J
AD  - Department of Gastroenterology, St Vincent's Hospital, 41 Victoria Parade, 
      Fitzroy, VIC, 3065, Australia.
AD  - Department of Medicine, University of Melbourne, Parkville, VIC, 3010, Australia.
AD  - Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, 
      VIC, 3004, Australia.
AD  - Department of Epidemiology and Preventative Medicine, Monash University, 
      Wellington Road, Clayton, VIC, 3800, Australia.
FAU - Valaydon, Zina
AU  - Valaydon Z
AD  - Department of Gastroenterology, Western Health, 160 Gordon Street, Footscray, 
      VIC, 3011, Australia.
FAU - Mack, Alexandra
AU  - Mack A
AD  - Department of Gastroenterology, Western Health, 160 Gordon Street, Footscray, 
      VIC, 3011, Australia.
FAU - Liu, Ken
AU  - Liu K
AD  - AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, 50 
      Missenden Road, Camperdown, NSW, 2050, Australia.
FAU - Dev, Anouk
AU  - Dev A
AD  - Department of Gastroenterology, Monash Health, 246 Clayton Road, Clayton, VIC, 
      3168, Australia.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20220825
PL  - United States
TA  - Hepatol Int
JT  - Hepatology international
JID - 101304009
RN  - 0 (Phenylurea Compounds)
RN  - 0 (Quinolines)
RN  - EE083865G2 (lenvatinib)
SB  - IM
MH  - Aged
MH  - Australia/epidemiology
MH  - *Carcinoma, Hepatocellular/pathology
MH  - Cohort Studies
MH  - Diarrhea/chemically induced/drug therapy
MH  - Female
MH  - Humans
MH  - *Hypertension/chemically induced/drug therapy
MH  - *Liver Neoplasms/pathology
MH  - Male
MH  - Phenylurea Compounds/adverse effects
MH  - *Quinolines/adverse effects
MH  - Retrospective Studies
PMC - PMC9525325
OTO - NOTNLM
OT  - Adverse effects
OT  - Australia
OT  - Chronic liver disease
OT  - Cohort
OT  - Diarrhoea
OT  - Hypertension
OT  - Liver malignancy
OT  - Multikinase inhibitor
OT  - Oral therapy
OT  - Systemic therapy
COIS- Kurvi Patwala, David Stephen Prince, Yael Celermajer, Waafiqa Alam, Eldho Paul, 
      Simone Irene Strasser, Geoffrey William McCaughan, Paul Gow, Siddharth Sood, 
      Elise Murphy, Stuart Roberts, Elliot Freeman, Elizabeth Stratton, Scott Anthony 
      Davison, Miriam Tania Levy, McCawley Clark-Dickson, Vi Nguyen, Sally Bell, Amanda 
      Nicoll, Ashley Bloom, Alice Unah Lee, Marno Ryan, Jessica Howell, Zina Valaydon, 
      Alexandra Mack, Ken Liu, and Anouk Dev have no relevant financial or 
      non-financial interests to disclose.
EDAT- 2022/08/26 06:00
MHDA- 2022/10/05 06:00
PMCR- 2022/08/25
CRDT- 2022/08/25 11:22
PHST- 2022/06/01 00:00 [received]
PHST- 2022/07/24 00:00 [accepted]
PHST- 2022/08/26 06:00 [pubmed]
PHST- 2022/10/05 06:00 [medline]
PHST- 2022/08/25 11:22 [entrez]
PHST- 2022/08/25 00:00 [pmc-release]
AID - 10.1007/s12072-022-10398-5 [pii]
AID - 10398 [pii]
AID - 10.1007/s12072-022-10398-5 [doi]
PST - ppublish
SO  - Hepatol Int. 2022 Oct;16(5):1170-1178. doi: 10.1007/s12072-022-10398-5. Epub 2022 
      Aug 25.