PMID- 38062925
OWN - NLM
STAT- MEDLINE
DCOM- 20240101
LR  - 20240123
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 24
DP  - 2023 Dec
TI  - Efficacy and outcome of molecular targeted therapies in elderly patients with 
      hepatocellular carcinoma: Relative dose intensity associated with overall 
      survival.
PG  - 22023-22037
LID - 10.1002/cam4.6783 [doi]
AB  - AIM: Indications of drug therapies to elderly patients with hepatocellular 
      carcinoma (HCC) should be carefully determined. The current study assessed the 
      safety and efficacy of molecular targeted agents (MTAs) in the elderly patients 
      with HCC, and identified factors associated with prognosis in a real-world 
      clinical setting. METHODS: In a retrospective observational study, clinical data 
      of patients with unresectable HCC treated with sorafenib or lenvatinib as 
      first-line treatment at our hospital between 2011 and 2022, were investigated. 
      Clinical parameters, therapeutic effects, adverse events (AEs), and prognosis 
      were evaluated separately for the non-elderly (<75 years old) and elderly 
      patients (>/=75 years old). RESULTS: Overall, 111 patients were enrolled, including 
      59 non-elderly and 52 elderly patients. Compared to the non-elderly patients, the 
      elderly patients had significantly lower skeletal muscle mass and a significantly 
      lower percentage of patients in poor general condition with performance status 2 
      or higher, but there were no differences in parameters related to liver function 
      or nutritional status. There were no significant differences in the incidence of 
      severe AEs and therapeutic effects between the groups. No significant difference 
      in progression-free survival was observed in the elderly and non-elderly 
      patients; however, overall survival (OS) for sorafenib treatment was shorter in 
      the elderly patients than in the non-elderly patients. Elderly patients consumed 
      lower doses of both the drugs, and relative dose intensity (RDI) 4 weeks after 
      treatment (4W-RDI) was associated with OS. Further, OS in the elderly patients 
      was significantly longer in the subgroup with high 4W-RDI as compared to that in 
      the subgroup with low 4W-RDI. CONCLUSIONS: MTAs can be safely administered to 
      elderly patients with HCC. Furthermore, 4W-RDI is associated with longer OS. 
      Maintaining RDI in the early phase is crucial in predicting the success of 
      treatment with MTAs, especially in the elderly patients.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Oura, Kyoko
AU  - Oura K
AUID- ORCID: 0000-0002-9531-7240
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Morishita, Asahiro
AU  - Morishita A
AUID- ORCID: 0000-0002-0760-3045
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Takuma, Kei
AU  - Takuma K
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Nakahara, Mai
AU  - Nakahara M
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Tadokoro, Tomoko
AU  - Tadokoro T
AUID- ORCID: 0000-0001-9975-386X
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Fujita, Koji
AU  - Fujita K
AUID- ORCID: 0000-0001-9390-7565
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Mimura, Shima
AU  - Mimura S
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Tani, Joji
AU  - Tani J
AUID- ORCID: 0000-0001-8801-2505
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Ono, Masafumi
AU  - Ono M
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
FAU - Himoto, Takashi
AU  - Himoto T
AD  - Department of Medical Technology, Kagawa Prefectural University of Health 
      Sciences, Kagawa, Japan.
FAU - Masaki, Tsutomu
AU  - Masaki T
AD  - Department of Gastroenterology and Neurology, Faculty of Medicine, Kagawa 
      University, Kagawa, Japan.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20231207
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
RN  - 9ZOQ3TZI87 (Sorafenib)
RN  - 0 (Antineoplastic Agents)
SB  - IM
MH  - Humans
MH  - Aged
MH  - Middle Aged
MH  - *Carcinoma, Hepatocellular/pathology
MH  - Sorafenib/therapeutic use
MH  - Molecular Targeted Therapy/adverse effects
MH  - *Liver Neoplasms/pathology
MH  - Treatment Outcome
MH  - *Antineoplastic Agents/adverse effects
PMC - PMC10757153
OTO - NOTNLM
OT  - hepatocellular carcinoma
OT  - lenvatinib
OT  - molecular targeted agent
OT  - sorafenib
OT  - tyrosine kinase inhibitor
COIS- The authors have no conflict of interest to declare.
EDAT- 2023/12/08 06:42
MHDA- 2024/01/02 11:46
PMCR- 2023/12/07
CRDT- 2023/12/08 03:48
PHST- 2023/11/16 00:00 [revised]
PHST- 2022/11/15 00:00 [received]
PHST- 2023/11/22 00:00 [accepted]
PHST- 2024/01/02 11:46 [medline]
PHST- 2023/12/08 06:42 [pubmed]
PHST- 2023/12/08 03:48 [entrez]
PHST- 2023/12/07 00:00 [pmc-release]
AID - CAM46783 [pii]
AID - 10.1002/cam4.6783 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Dec;12(24):22023-22037. doi: 10.1002/cam4.6783. Epub 2023 Dec 7.