Next Article in Journal
Fluorescence-Guided Surgery in Colorectal Cancer: State-of-the-Art and Translational Perspectives
Previous Article in Journal
Primary Intracranial Squamous Cell Carcinoma Arising from an Epidermoid Cyst: Successful Management with Subtotal Resection and Gamma Knife Radiosurgery in an Elderly Patient
 
 
Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
Journals
Current Oncology
Volume 33
Issue 3
10.3390/curroncol33030159
curroncol-logo
Submit to this Journal Review for this Journal Propose a Special Issue
► Article Menu

Article Menu

share Share announcement Help format_quote Cite question_answer Discuss in SciProfiles
first_page
settings
Order Article Reprints
Font Type:
Arial Georgia Verdana
Font Size:
Aa Aa Aa
Line Spacing:
Column Width:
Background:
Article

Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma

by
Daichi Takizawa
1,
Hirotaka Arai
1,
Mitsuhiko Shibasaki
1,
Yuki Tamura
1,
Satoru Kakizaki
2,*,
Takeshi Hatanaka
3,
Atsushi Naganuma
4,
Takashi Ueno
5,
Toru Fukuchi
6,
Masashi Namikawa
7,
Satoshi Takakusagi
8,
Shuichi Saito
9,
Takayoshi Suga
10,
Hiroki Tojima
11,
Yuichi Yamazaki
11 and
Toshio Uraoka
11
1
Department of Gastroenterology, Maebashi Red Cross Hospital, Maebashi 371-0811, Japan
2
Department of Clinical Research, NHO Takasaki General Medical Center, Takasaki 370-0829, Japan
3
Department of Gastroenterology, Gunma Saiseikai Maebashi Hospital, Maebashi 371-0821, Japan
4
Department of Gastroenterology, NHO Takasaki General Medical Center, Takasaki 370-0829, Japan
5
Department of Internal Medicine, Isesaki Municipal Hospital, Isesaki 372-0817, Japan
6
Department of Internal Medicine, Kiryu Kosei General Hospital, Kiryu 376-0024, Japan
7
Department of Gastroenterology, Subaru Health Insurance Society Ota Memorial Hospital, Ota 373-8585, Japan
8
Department of Gastroenterology and Hepatology, Kusunoki Hospital, Fujioka 375-0024, Japan
9
Department of Gastroenterology, Public Tomioka General Hospital, Tomioka 370-2393, Japan
10
Department of Gastroenterology, NHO Shibukawa Medical Center, Shibukawa 377-0280, Japan
11
Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi 371-8511, Japan
 
add Show full affiliation list
 
remove Hide full affiliation list
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2026, 33(3), 159; https://doi.org/10.3390/curroncol33030159
Submission received: 5 February 2026 / Revised: 2 March 2026 / Accepted: 9 March 2026 / Published: 11 March 2026
(This article belongs to the Section Gastrointestinal Oncology)
Browse Figures
Versions Notes

Simple Summary

Atezolizumab plus bevacizumab is used as first-line treatment for advanced hepatocellular carcinoma, but evidence regarding subsequent second-line therapy remains insufficient. This multicenter collaborative study retrospectively examined cases treated with lenvatinib as second-line therapy. Results showed that patients receiving lenvatinib had improved survival compared with those who did not receive it. Additionally, factors contributing to prognosis in patients receiving lenvatinib as second-line therapy included hepatic reserve before first-line treatment and a total lenvatinib dose of 400 mg or more. Maintaining hepatic reserve through appropriate dose management was considered important. These findings provide clinically useful information regarding the feasibility of sequential systemic therapy following atezolizumab plus bevacizumab treatment and highlight factors associated with preserved hepatic reserve and treatment continuation in routine clinical practice.

Abstract

Background: Atezolizumab plus bevacizumab (ATZ/BEV) is widely used as first-line therapy for advanced hepatocellular carcinoma (HCC); however, optimal subsequent treatment after ATZ/BEV failure remains unclear. Methods: Between October 2020 and August 2024, 165 patients with unresectable HCC treated with first-line ATZ/BEV were retrospectively analyzed. After excluding patients with insufficient follow-up, outcomes were compared between those who received lenvatinib (LEN) as second-line therapy (n = 49) and those who did not (n = 95). Results: Median overall survival (OS) was significantly longer in the LEN group than in the non-LEN group (20.9 vs. 8.47 months, p < 0.01). LEN administration was independently associated with improved OS (hazard ratio 0.48), and this benefit remained significant after inverse probability weighting adjustment (adjusted hazard ratio 0.50). Among LEN-treated patients, a lower albumin–bilirubin score before ATZ/BEV and a total LEN dose ≥ 400 mg were independent prognostic factors. Conclusions: Lenvatinib as second-line therapy after ATZ/BEV was associated with improved survival in unresectable HCC. Preservation of liver function and the ability to maintain adequate lenvatinib exposure were associated with favorable outcomes, likely reflecting baseline prognosis and treatment feasibility rather than lenvatinib-specific predictive factors.
Keywords: lenvatinib; atezolizumab; bevacizumab; second-line; hepatocellular carcinoma lenvatinib; atezolizumab; bevacizumab; second-line; hepatocellular carcinoma

Share and Cite

MDPI and ACS Style

Takizawa, D.; Arai, H.; Shibasaki, M.; Tamura, Y.; Kakizaki, S.; Hatanaka, T.; Naganuma, A.; Ueno, T.; Fukuchi, T.; Namikawa, M.; et al. Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Curr. Oncol. 2026, 33, 159. https://doi.org/10.3390/curroncol33030159

AMA Style

Takizawa D, Arai H, Shibasaki M, Tamura Y, Kakizaki S, Hatanaka T, Naganuma A, Ueno T, Fukuchi T, Namikawa M, et al. Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Current Oncology. 2026; 33(3):159. https://doi.org/10.3390/curroncol33030159

Chicago/Turabian Style

Takizawa, Daichi, Hirotaka Arai, Mitsuhiko Shibasaki, Yuki Tamura, Satoru Kakizaki, Takeshi Hatanaka, Atsushi Naganuma, Takashi Ueno, Toru Fukuchi, Masashi Namikawa, and et al. 2026. "Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma" Current Oncology 33, no. 3: 159. https://doi.org/10.3390/curroncol33030159

APA Style

Takizawa, D., Arai, H., Shibasaki, M., Tamura, Y., Kakizaki, S., Hatanaka, T., Naganuma, A., Ueno, T., Fukuchi, T., Namikawa, M., Takakusagi, S., Saito, S., Suga, T., Tojima, H., Yamazaki, Y., & Uraoka, T. (2026). Efficacy of Lenvatinib as Second-Line Therapy After Atezolizumab Plus Bevacizumab for Hepatocellular Carcinoma. Current Oncology, 33(3), 159. https://doi.org/10.3390/curroncol33030159

Article Metrics

Back to TopTop