Impact of Lenvatinib Outcome in Patients of' Hepatocellular Carcinoma
DOI:
https://doi.org/10.70749/ijbr.v3i7.2059Keywords:
Hepatocellular carcinoma, Lenvatinib, Objective response rate, Disease control rate, Advanced HCC, Targeted therapyAbstract
Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide, with limited treatment options for advanced-stage disease. Lenvatinib, a multi-kinase inhibitor, has emerged as an effective first-line systemic therapy, demonstrating promising clinical outcomes in large international trials. However, real-world data in Pakistani population is lacking. Objective: This study aimed to evaluate the clinical efficacy and disease control outcomes of lenvatinib monotherapy in patients with advanced HCC treated at a tertiary care center in Pakistan. Methods: A descriptive case series was conducted at the Department of Medical Oncology, Hameed Latif Hospital, Lahore, including 94 patients with advanced HCC diagnosed based on clinical and radiological criteria. The study was conducted during January to June, 2025. Patients received weight-based lenvatinib therapy (12 mg or 8 mg daily), and treatment response was assessed using the modified RECIST criteria via imaging. Data were analyzed using SPSS version 27, with frequencies, percentages, and chi-square tests applied where relevant. Results: The mean age of patients was 58.4 ± 9.7 years, with 68.1% being male. Hepatitis C was the most common underlying etiology (60.6%), followed by hepatitis B (39.4%). Common comorbidities included hypertension (44.7%) and diabetes mellitus (41.5%). Treatment response showed a complete response in 6.4%, partial response in 29.8%, stable disease in 37.2%, and progressive disease in 26.6% of patients. The objective response rate (ORR) was 24.1%, and the disease control rate (DCR) was 73.4%, consistent with outcomes reported in global trials. Lenvatinib was well tolerated, with no treatment-related deaths observed. Conclusion: Lenvatinib demonstrated clinically meaningful efficacy in terms of tumor response and disease control among patients with advanced HCC in a real-world setting. These findings support its continued use as a first-line treatment and highlight the importance of individualized patient assessment to optimize therapeutic outcomes.
Downloads
References
1. Wang DX, Yang X, Lin JZ, Bai Y, Long JY, Yang XB et al. Efficacy and safety of lenvatinib for patients with advanced hepatocellular carcinoma: A retrospective, real-world study conducted in China. World J Gastroenterol 2020; 26(30): 4465-4478.
https://doi.org/10.3748/wjg.v26.i30.4465
2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018; 68: 394-424
https://doi.org/10.3322/caac.21492
3. Marquardt JU, Saborowski A, Czauderna C, Vogel A. The Changing Landscape of Systemic Treatment of Advanced Hepatocellular Carcinoma: New Targeted Agents and Immunotherapies. Target Oncol 2019; 14:115-123.
https://doi.org/10.1007/s11523-019-00624-w
4. Obi S, Sato T, Sato S, Kanda M, Tokudome Y, Kojima Y et al. The efficacy and safety of lenvatinib for advanced hepatocellular carcinoma in a real-world setting. Hepatol Int 2019; 13: 199-204.
https://doi.org/10.1007/s12072-019-09929-4
5. Sasaki R, Fukushima M, Haraguchi M, Miuma S, Miyaaki H, Hidaka M et al. Response to Lenvatinib Is Associated with Optimal RelativeDose Intensity in Hepatocellular Carcinoma: Experience in Clinical Settings. Cancers (Basel) 2019; 11: 1769.
https://doi.org/10.3390/cancers11111769
6. Amioka K, Kawaoka T, Kosaka M, Johira Y, Shirane Y, Miura R et al. Analysis of Survival and Response to Lenvatinib in Unresectable Hepatocellular Carcinoma. Cancers (Basel). 2022 10;14(2):320.
https://doi.org/10.3390/cancers14020320
7. Zhu, Y., Sun, P., Wang, K. et al. Efficacy and safety of lenvatinib monotreatment and lenvatinib-based combination therapy for patients with unresectable hepatocellular carcinoma: a retrospective, real-world study in China. Cancer Cell Int 21, 503 (2021).
https://doi.org/10.1186/s12935-021-02200-7
8. Finn RS, Ikeda M, Zhu AX, Sung MW, Baron AD, Kudo M, Okusaka T, Kobayashi M, Kumada H, Kaneko S, et al. Phase Ib study of lenvatinib plus pembrolizumab in patients with unresectable hepatocellular carcinoma. J Clin Oncol. 2020;38(26):2960–70.
https://doi.org/10.1200/jco.20.00808
9. Kudo M, Finn RS, Qin S, et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial. Lancet. 2018;391(10126):1163–1173.
https://doi.org/10.1016/s0140-6736(18)30207-1
10. Li D, Sedano S, Allen R, Gong J, Cho M, Sharma S. Current treatment landscape for advanced hepatocellular carcinoma: patient outcomes and the impact on quality of life. Cancers. 2019 18;11(6):841.
https://doi.org/10.3390/cancers11060841
11. Tsuchiya K, Kurosaki M, Sakamoto A, et al. The real-world data in Japanese patients with unresectable hepatocellular carcinoma treated with lenvatinib from a nationwide multicenter study. Cancers. 2021;13(11):2608.
https://doi.org/10.3390/cancers13112608
12. Tahir M. Hepatocellular carcinoma: Hope and challenges. CA Cancer J Clin. 2022;72(7).
https://journals.lnh.edu.pk/lnjcc/pdf/9c0c7f96-f09f-4c44-a633-d1ef0c8d18d6.pdf
13. Takeda H, Nishikawa H, Osaki Y et al Clinical features associated with radiological response to sorafenib in unresectable hepatocellular carcinoma: a large multicenter study in Japan. Liver Int 2015; 35: 1581–1589.
https://doi.org/10.1111/liv.12591
14. Cainap C, Qin S, Huang WT et al Linifanib versus sorafenib in patients with advanced hepatocellular carcinoma: results of a randomized phase III trial. J Clin Oncol 2015; 33: 172–179.
https://doi.org/10.1200/jco.2013.54.3298
15. Johnson PJ, Qin S, Park JW et al Brivanib versus sorafenib as first‐line therapy in patients with unresectable, advanced hepatocellular carcinoma: results from the randomized phase III BRISK‐FL study. J Clin Oncol 2013; 31: 3517–3524.
https://doi.org/10.1200/jco.2012.48.4410
16. Ikeda K, Kudo M, Kawazoe S et al Phase 2 study of lenvatinib in patients with advanced hepatocellular carcinoma. J Gastroenterol 2017; 52: 512–519.
https://doi.org/10.1007/s00535-016-1263-4
17. Hiraoka A, Kumada T, Kariyama K et al Therapeutic potential of lenvatinib for unresectable hepatocellular carcinoma in clinical practice: multicenter analysis. Hepatol Res 2018.
https://doi.org/10.1111/hepr.13243.
18. Han KH. Treatment of Hepatocellular Carcinoma With Lenvatinib. Gastroenterol Hepatol (N Y). 2018 Nov;14(11):662-664.
19. Surov, A., Thormann, M. & Hinnerichs, M. Impact of body composition in advanced hepatocellular carcinoma: A subanalysis of the SORAMIC trial. Hepatol. Commun. 7(6), e0165.
https://doi.org/10.1097/HC9.0000000000000165
20. Shimozato, N. et al. Efficacy and safety of lenvatinib for patients with advanced hepatocellular carcinoma: A retrospective, real-world study conducted in Japan. Anticancer Res. 42(1), 173–183.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
