Cancer medicine · 2026
A Real-World Experience of Prognostic Factors of Survival Outcomes in a Taiwanese Population With Unresectable Hepatocellular Carcinoma Treated With First-Line Lenvatinib.
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Lee Shou-Wu, Huang Yi-Jie, Tsai Hsin-Ju, Lin Ying-Cheng, Chen Chia-Chang, Lee Teng-Yu, Chun-Peng Yen
Аннотация
INTRODUCTION: Lenvatinib is approved as a first-line treatment for unresectable hepatocellular carcinoma (HCC), but real-world outcomes may vary due to patient heterogeneity. This study aimed to evaluate the real-world efficacy of lenvatinib in Taiwanese patients and to identify prognostic factors influencing outcomes.
METHODS: This retrospective cohort study included 111 patients with unresectable HCC treated with the first-line lenvatinib between February 2020 and April 2023 at Taichung Veterans General Hospital. All patients were Child-Pugh class A and had at least one measurable lesion per mRECIST. Radiological tumor response, overall survival (OS), and progression-free survival (PFS) were recorded and analyzed.
RESULTS: The ORR and DCR were 36% and 81% respectively. The median OS of all patients was 17 months, and PFS was 10 months. Patients with ALBI grade 1 (HR 0.45, 95% CI 0.24-0.84, p = 0.011) and receiving combined locoregional therapy (LRT) (HR 0.38, 95% CI 0.20-0.79, p = 0.003) had significantly longer OS. AFP ≤ 400 ng/mL was associated with longer PFS (HR 0.35, 95% CI 0.35-0.94, p = 0.028).
CONCLUSION: Lenvatinib is effective in real-world treatment of unresectable HCC, especially when combined with LRT. ALBI grade 1 and AFP ≤ 400 ng/mL are favorable prognostic indicators for survival and disease control. These findings support personalized treatment strategies and warrant further prospective validation.
METHODS: This retrospective cohort study included 111 patients with unresectable HCC treated with the first-line lenvatinib between February 2020 and April 2023 at Taichung Veterans General Hospital. All patients were Child-Pugh class A and had at least one measurable lesion per mRECIST. Radiological tumor response, overall survival (OS), and progression-free survival (PFS) were recorded and analyzed.
RESULTS: The ORR and DCR were 36% and 81% respectively. The median OS of all patients was 17 months, and PFS was 10 months. Patients with ALBI grade 1 (HR 0.45, 95% CI 0.24-0.84, p = 0.011) and receiving combined locoregional therapy (LRT) (HR 0.38, 95% CI 0.20-0.79, p = 0.003) had significantly longer OS. AFP ≤ 400 ng/mL was associated with longer PFS (HR 0.35, 95% CI 0.35-0.94, p = 0.028).
CONCLUSION: Lenvatinib is effective in real-world treatment of unresectable HCC, especially when combined with LRT. ALBI grade 1 and AFP ≤ 400 ng/mL are favorable prognostic indicators for survival and disease control. These findings support personalized treatment strategies and warrant further prospective validation.