6533b85afe1ef96bd12b97c6
RESEARCH PRODUCT
Nonalcoholic steatohepatitis in hepatocarcinoma: new insights about its prognostic role in patients treated with lenvatinib
T. IshikawaM. ImaiNoritomo ShimadaKazuya KariyamaShinya FukunishiAkemi TsutsuiMasashi HirookaHideki IwamotoNorio ItokawaAtsushi HiraokaTomomi OkuboEi ItobayashiKazuhito KawataJoji TaniYoichi HiasaKouji JokoN. SakamotoF. MarraTaeang AraiKoichi TakaguchiFrancesco Giuseppe FoschiMasanori AtsukawaYohei KoizumiMarianna SillettaMassimo IavaroneTakuya NaganoJ. SieblerStefano CascinuT. ShoMargherita RiminiS. ShigeoT. AokiL. AldrighettiToshifumi TadaG. SudaA. JefremowV. BurgioTakashi NiizekiHidenori ToyodaGianluca MasiSara LonardiKazuto TajiriF. RattiShinichiro NakamuraW. KangW. KangA. CucchettiTakashi KumadaRaffaella TortoraE. TamburiniKunihiko TsujiSatoshi YasudaFabio PiscagliaHiroshi ShibataKazuhiro NousoGiuseppe CabibboK. UeshimaHironori OchiAndrea Casadei-gardiniHideko OhamaT. TakaakiM. KudoM.j. Gohsubject
OncologyPhenylurea CompoundatezolizumabCancer Researchmedicine.medical_specialtyCarcinoma HepatocellularQuinolinelenvatinibbevacizumabchemistry.chemical_compoundLiver diseaseRetrospective StudieNon-alcoholic Fatty Liver DiseaseInternal medicineMedicineHumansnonalcoholic steatohepatitisOriginal ResearchRetrospective StudiesUnivariate analysisSettore MED/12 - GastroenterologiaPerformance statusbusiness.industryPhenylurea CompoundsHazard ratioLiver NeoplasmsRetrospective cohort studyHepatitis Chepatocellular carcinomamedicine.diseasePrognosisdigestive system diseasesadvanced hepatocarcinoma; atezolizumab; bevacizumab; hepatitis C; hepatocellular carcinoma; immunotherapy; lenvatinib; nonalcoholic steatohepatitis; sorafenibadvanced hepatocarcinomaOncologychemistryLiver NeoplasmHepatocellular carcinomanonalcoholic steatohepatitiQuinolinessorafenibimmunotherapyhepatitis CbusinessLenvatinibHumandescription
Background Hepatocellular carcinoma (HCC) treatment remains a big challenge in the field of oncology. The liver disease (viral or not viral) underlying HCC turned out to be crucial in determining the biologic behavior of the tumor, including its response to treatment. The aim of this analysis was to investigate the role of the etiology of the underlying liver disease in survival outcomes. Patients and methods We conducted a multicenter retrospective study on a large cohort of patients treated with lenvatinib as first-line therapy for advanced HCC from both Eastern and Western institutions. Univariate and multivariate analyses were performed. Results Among the 1232 lenvatinib-treated HCC patients, 453 (36.8%) were hepatitis C virus positive, 268 hepatitis B virus positive (21.8%), 236 nonalcoholic steatohepatitis (NASH) correlate (19.2%) and 275 had other etiologies (22.3%). The median progression-free survival (mPFS) was 6.2 months [95% confidence interval (CI) 5.9-6.7 months] and the median overall survival (mOS) was 15.8 months (95% CI 14.9-17.2 months). In the univariate analysis for OS NASH-HCC was associated with longer mOS [22.2 versus 15.1 months; hazard ratio (HR) 0.69; 95% CI 0.56-0.85; P = 0.0006]. In the univariate analysis for PFS NASH-HCC was associated with longer mPFS (7.5 versus 6.5 months; HR 0.84; 95% CI 0.71-0.99; P = 0.0436). The multivariate analysis confirmed NASH-HCC (HR 0.64; 95% CI 0.48-0.86; P = 0.0028) as an independent prognostic factor for OS, along with albumin–bilirubin (ALBI) grade, extrahepatic spread, neutrophil-to-lymphocyte ratio, portal vein thrombosis, Eastern Cooperative Oncology Group (ECOG) performance status and alpha-fetoprotein. An interaction test was performed between sorafenib and lenvatinib cohorts and the results highlighted the positive predictive role of NASH in favor of the lenvatinib arm (P = 0.0047). Conclusion NASH has been identified as an independent prognostic factor in a large cohort of patients with advanced HCC treated with lenvatinib, thereby suggesting the role of the etiology in the selection of patients for tyrosine kinase treatment. If validated, this result could provide new insights useful to improve the management of these patients.
year | journal | country | edition | language |
---|---|---|---|---|
2021-01-01 |