Identification of lenvatinib prognostic index via recursive partitioning analysis in advanced hepatocellular carcinoma.

Carcinoma, Hepatocellular / drug therapy Chemoembolization, Therapeutic Humans Liver Neoplasms / drug therapy Phenylurea Compounds Prognosis Quinolines
hepatocellular carcinoma lenvatinib prognostic index recursive partitioning analysis

Journal

ESMO open
ISSN: 2059-7029
Titre abrégé: ESMO Open
Pays: England
ID NLM: 101690685

Informations de publication

Date de publication:
08 2021
Historique:
received: 19 04 2021
revised: 25 05 2021
accepted: 26 05 2021
pubmed: 19 6 2021
medline: 30 10 2021
entrez: 18 6 2021
Statut: ppublish

Résumé

After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient. With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib. The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage B (BCLC-B)]; high risk [patients with PNI <43.3 and ALBI grade 2 and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage C (BCLC-C)]. Median overall survival was 29.8 months [95% confidence interval (CI) 22.8-29.8 months] in low risk patients (n = 128), 17.0 months (95% CI 15.0-24.0 months) in medium risk (n = 162) and 8.9 months (95% CI 8.0-10.7 months) in high risk (n = 114); low risk hazard ratio (HR) 1 (reference group), medium risk HR 1.95 (95% CI 1.38-2.74), high risk HR 4.84 (95% CI 3.16-7.43); P < 0.0001. The LEP index was validated in a cohort of 127 Italian patients treated with lenvatinib. While the same classification did not show a prognostic value in a cohort of 311 patients treated with sorafenib, we also show a possible predictive role in favor of lenvatinib in the low risk group. LEP index is a promising, easy-to-use tool that may be used to stratify patients undergoing systemic treatment of advanced HCC.

Sections du résumé

BACKGROUND
After the advent of new treatment options for advanced hepatocellular carcinoma (HCC), the identification of prognostic factors is crucial for the selection of the most appropriate therapy for each patient.
PATIENTS AND METHODS
With the aim to fill this gap, we applied recursive partitioning analysis (RPA) to a cohort of 404 patients treated with lenvatinib.
RESULTS
The application of RPA resulted in a classification based on five variables that originated a new prognostic score, the lenvatinib prognostic index (LEP) index, identifying three groups: low risk [patients with prognostic nutritional index (PNI) >43.3 and previous trans-arterial chemoembolization (TACE)]; medium risk [patients with PNI >43.3 but without previous TACE and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage B (BCLC-B)]; high risk [patients with PNI <43.3 and ALBI grade 2 and patients with PNI <43.3, albumin-bilirubin (ALBI) grade 1 and Barcelona Clinic Liver Cancer stage C (BCLC-C)]. Median overall survival was 29.8 months [95% confidence interval (CI) 22.8-29.8 months] in low risk patients (n = 128), 17.0 months (95% CI 15.0-24.0 months) in medium risk (n = 162) and 8.9 months (95% CI 8.0-10.7 months) in high risk (n = 114); low risk hazard ratio (HR) 1 (reference group), medium risk HR 1.95 (95% CI 1.38-2.74), high risk HR 4.84 (95% CI 3.16-7.43); P < 0.0001. The LEP index was validated in a cohort of 127 Italian patients treated with lenvatinib. While the same classification did not show a prognostic value in a cohort of 311 patients treated with sorafenib, we also show a possible predictive role in favor of lenvatinib in the low risk group.
CONCLUSIONS
LEP index is a promising, easy-to-use tool that may be used to stratify patients undergoing systemic treatment of advanced HCC.

Identifiants

DOI: 10.1016/j.esmoop.2021.100190 PMID: 34144271 PMC: PMC8219999
pubmed: 34144271
pii: S2059-7029(21)00151-4
doi: 10.1016/j.esmoop.2021.100190
pmc: PMC8219999
pii:
doi:

Substances chimiques

Phenylurea Compounds 0
Quinolines 0
lenvatinib EE083865G2

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

100190

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure The authors have declared no conflicts of interest. Data sharing Data are available upon reasonable request.

Auteurs

I G Rapposelli (IG)

Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori'-IRST, Meldola, Italy.

S Shimose (S)

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

T Kumada (T)

Faculty of Nursing, Gifu Kyoritsu University, Ogaki, Japan.

S Okamura (S)

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

A Hiraoka (A)

Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Japan.

G G Di Costanzo (GG)

Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy.

F Marra (F)

Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Florence, Italy.

E Tamburini (E)

Department of Medical Oncology, Card. G. Panico Hospital of Tricase, Tricase, Italy.

A Forgione (A)

Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.

F G Foschi (FG)

Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy.

M Silletta (M)

Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy.

S Lonardi (S)

Early Phase Clinical Trial Unit, Department of Oncology, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy; Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.

G Masi (G)

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

M Scartozzi (M)

Medical Oncology, University and University Hospital of Cagliari, Italy.

M Nakano (M)

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

H Shibata (H)

Department of Gastroenterology, Tokushima Prefectural Central Hospital, Tokushima, Japan.

K Kawata (K)

Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan.

A Pellino (A)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy; Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy.

C Vivaldi (C)

Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy; Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

E Lai (E)

Medical Oncology, University and University Hospital of Cagliari, Italy.

A Takata (A)

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

K Tajiri (K)

Department of Gastroenterology, Toyama University Hospital, Toyama, Japan.

H Toyoda (H)

Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan.

R Tortora (R)

Liver Unit, Department of Transplantation, Cardarelli Hospital, Naples, Italy.

C Campani (C)

Dipartimento di Medicina Sperimentale e Clinica, University of Florence, Florence, Italy.

M G Viola (MG)

Department of Surgery, Card. G. Panico Hospital of Tricase, Tricase, Italy.

F Piscaglia (F)

Division of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Italy.

F Conti (F)

Department of Internal Medicine, Faenza Hospital, AUSL Romagna, Faenza, Italy.

C A M Fulgenzi (CAM)

Medical Oncology Unit, University Campus Bio-Medico, Rome, Italy.

G L Frassineti (GL)

Department of Medical Oncology, IRCCS Istituto Romagnolo per lo Studio dei Tumori 'Dino Amadori'-IRST, Meldola, Italy.

M D Rizzato (MD)

Medical Oncology Unit 1, Department of Oncology, Veneto Institute of Oncology IOV - IRCCS, Padua, Italy.

F Salani (F)

Unit of Medical Oncology 2, Azienda Ospedaliero-Universitaria Pisana, Pisa, Italy.

G Astara (G)

Medical Oncology, University and University Hospital of Cagliari, Italy.

T Torimura (T)

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

M Atsukawa (M)

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Nippon Medical School, Tokyo, Japan.

T Tada (T)

Department of Internal Medicine, Japanese Red Cross Himeji Hospital, Himeji, Japan.

V Burgio (V)

Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy.

M Rimini (M)

Department of Oncology and Hematology, Division of Oncology, University Hospital of Modena, Modena, Italy.

S Cascinu (S)

Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.

A Casadei-Gardini (A)

Unit of Oncology, IRCCS San Raffaele Scientific Institute, Milan, Italy; School of Medicine, Vita-Salute San Raffaele University, Milan, Italy. Electronic address: casadeigardini@gmail.com.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Carcinome hépatocellulaire › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Thérapeutique › Occlusion thérapeutique › Embolisation thérapeutique › Chimioembolisation thérapeutique › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies du foie › Tumeurs du foie › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Composés chimiques organiques › Hydrocarbures › Hydrocarbures cycliques › Hydrocarbures aromatiques › Dérivés du benzène › Phénylurées › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Diagnostic › Pronostic › Identification of lenvatinib prognostic index...
questionsmedicales.fr › Composés hétérocycliques › Composés hétérocycliques à cycles fusionnés › Composés hétérobicycliques › Quinoléines › Identification of lenvatinib prognostic index...