Evolution of Survival Impact of Molecular Target Agents in Patients with Advanced Hepatocellular Carcinoma

Liver Cancer

Michihisa Moriguchi¹  Aya Takahashi¹  Yuya Seko¹  Yoshito Itoh¹  Hiroaki Kanzaki²  Naoya Kato²  Tatsuo Kanda²  Jun Kato²  Keisuke Koroki²  Tetsuhiro Chiba²  Masato Nakamura²  Terunao Iwanaga²  Akinobu Tawada²  Kazufumi Kobayashi²  Takamasa Ishino²  Takayuki Kondo²  Takafumi Sakuma²  Naoto Fujita²  Soichiro Kiyono²  Hitoshi Maruyama²  Tomoko Saito²  Yoshihiko Ooka²  Sadahisa Ogasawara²  Hidemi Unozawa²  Shingo Nakamoto²  Naoya Kanogawa²  Keita Ogawa²  Makoto Arai²  Eiichiro Suzuki²  Ryo Nakagawa²  Shunji Watanabe³  Naoki Morimoto³  Norio Isoda³  Kenji Iwai⁴  Satoshi Tsuchiya⁴  Rui Sato⁴  Takeshi Aramaki⁴  Masanori Inoue⁵  Kengo Nagashima⁶ 

[1] Department of Gastroenterology and Hepatology, Kyoto Prefectural University of Medicine, Kyoto, Japan;

[2] Department of Gastroenterology, Graduate School of Medicine, Chiba University, Chiba, Japan;

[3] Division of Gastroenterology, Department of Medicine, Jichi Medical University, Tochigi, Japan;

[4] Division of Interventional Radiology, Shizuoka Cancer Center, Shizuoka, Japan;

[5] Numazu City Hospital, Shizuoka, Japan;

[6] Research Center for Medical and Health Data Science, The Institute of Statistical Mathematics, Tokyo, Japan;

关键词: sequential therapy;    sorafenib;    regorafenib;    lenvatinib;    ramucirumab;   

DOI  :  10.1159/000519868

来源: DOAJ

【 摘 要 】

Background and Aims: The prognosis of patients with advanced hepatocellular carcinoma (HCC) is expected to improve as multiple molecular target agents (MTAs) are now available. However, the impact of the availability of sequential MTAs has not been fully verified yet. Approach and Results: We retrospectively collected the data on the whole clinical course of 877 patients who received any MTAs as first-line systemic therapy for advanced HCC between June 2009 and March 2019. The study population was divided into 3 groups according to the date of first-line MTA administration (period 1: 2009–2012, n = 267; period 2: 2013–2016, n = 352; period 3: 2017–2019, n = 258). Then, we compared the number of MTAs used, overall survival (OS), and MTA treatment duration among the 3 groups. Analysis was also performed separately for advanced-stage and nonadvanced-stage HCC. The proportion of patients who received multiple MTAs was remarkably increased over time (1.1%, 10.2%, and 42.6% in periods 1, 2, and 3, respectively, p < 0.001). The median OS times were prolonged to 10.4, 11.3, and 15.2 months in periods 1, 2, and 3, respectively (p = 0.016). Similarly, the MTA treatment durations were extended (2.7, 3.2, and 6.6 months in periods 1, 2, and 3, respectively; p < 0.001). We confirmed that the correlation between OS and MTA treatment duration was strengthened (period 1: 0.395, period 2: 0.505, and period 3: 0.667). All these trends were pronounced in the patients with advanced-stage HCC but limited in the patients with nonadvanced-stage HCC. Conclusions: The availability of multiple MTAs had steadily improved the prognosis of patients with advanced HCC patients, particularly advanced-stage HCC patients.

【 授权许可】

Unknown