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Open AccessArticle

Response to Lenvatinib Is Associated with Optimal RelativeDose Intensity in Hepatocellular Carcinoma: Experience in Clinical Settings

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Department of Gastroenterology and Hepatology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan
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Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki City, Nagasaki 852-8501, Japan
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Gastroenterology and Hepatology, Sasebo City General Hospital, 9-3 Hirase-cho, Sasebo City, Nagasaki 857-8511, Japan
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Gastroenterology and Hepatology, Japan Community Health Care Organization, Isahaya General Hospital, 24-1 Eishohigashi-machi, Isahaya City, Nagasaki 854-8501, Japan
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Clinical Research Center, National Hospital Organization Nagasaki Medical Center, 2-1001-1 Kubara, Oomura City, Nagasaki 856-8562, Japan
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Gastroenterology and Hepatology, Nagasaki Harbor Medical Centor, 6-39 Shinchi-machi, Nagasaki City, Nagasaki 850-8798, Japan
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Gastroenterology and Hepatology, Japanese Red Cross Nagasaki Genbaku Hospital, 3-15 Mori-machi, Nagasaki City, Nagasaki 852-8511, Japan
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Gastroenterology and Hepatology, Sasebo Chuo Hospital, 15 Yamato-cho, Sasebo City, Nagasaki 857-1195, Japan
*
Author to whom correspondence should be addressed.
Cancers 2019, 11(11), 1769; https://doi.org/10.3390/cancers11111769 (registering DOI)
Received: 15 October 2019 / Revised: 4 November 2019 / Accepted: 8 November 2019 / Published: 10 November 2019
Background: Lenvatinib is currently available as the first-line treatment for advanced unresectable hepatocellular carcinoma. We evaluated the relationship between its relative dose intensity (RDI) and response in clinical settings. Methods: From March 2018 to May 2019, 93 patients were administered lenvatinib at the Nagasaki University Hospital and its related facilities. Among these, 81 patients (66 men, 15 women, median age 72.0) who received lenvatinib were analyzed retrospectively. Results: Fourteen patients were Child–Pugh grade B, and 15 had received other systemic therapy. According to Response Evaluation Criteria in Solid Tumors (RECIST), the objective response (OR) rate was 17.3%. The overall survival (OS) was significantly better in the OR group (p = 0.011). There was a significant difference in RDI between the OR and non-OR groups (p < 0.05). The area under the receiver operating characteristics curve for OR prediction by the 4, 8, 12, and 16-week RDI were 0.666, 0.747, 0.731, and 0.704, respectively. In the 8-week RDI ≥67.0% group, OS was significantly better than in the 8-week RDI <67.0% group (p = 0.003). Conclusions: Because a sufficient RDI is required to achieve an OR, it is strongly recommended that lenvatinib should be administered to patients with good hepatic function and status. View Full-Text
Keywords: hepatocellular carcinoma; lenvatinib; relative dose intensity hepatocellular carcinoma; lenvatinib; relative dose intensity
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Sasaki, R.; Fukushima, M.; Haraguchi, M.; Miuma, S.; Miyaaki, H.; Hidaka, M.; Eguchi, S.; Matsuo, S.; Tajima, K.; Matsuzaki, T.; Hashimoto, S.; Ooba, K.; Kugiyama, Y.; Yatsuhashi, H.; Motoyoshi, Y.; Shigeno, M.; Kinoshita, N.; Nakao, K. Response to Lenvatinib Is Associated with Optimal RelativeDose Intensity in Hepatocellular Carcinoma: Experience in Clinical Settings. Cancers 2019, 11, 1769.

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