Own Experience of Using Lenvatinib in Patients with Advanced Hepatocellular Carcinoma in Real Clinical Practice based on Moscow City Oncological Hospital №62

Abstract

Background. Hepatocellular carcinoma (HCC) (hepatocarcinoma) is the most common (about 85% of cases) malignant liver tumor originating from hepatocytes. According to officially published statistics for the city of Moscow for 2019,329 people were registered with the first-ever diagnosed C22 malignant neoplasms (liver and intrahepatic bile ducts, including 6.7% of those who were actively identified. The absolute number of such patients registered at the end of the year was 716, which is 5.7 per 100 000 of the population. The contingent accumulation index is 2.2 (the average for Russia is 1.5). With that,43.1% of patients had stage IV. Mortality rate during the first year after diagnosis is 53.9% (in Russia on the whole, this value is 66.5%). Drug systemic therapy is the method of choice for HCC which is not subject to surgical intervention and local methods of treatment.
 Materials and methods. A retrospective analysis of the efficacy and safety of lenvatinib in patients diagnosed with HCC was carried out in real clinical practice at the Outpatient Oncology Care Center of the Moscow City Oncological Hospital №62. The data analysis covers the period from February 2016 to June 2021. The analysis included 15 patients with a morphologically verified diagnosis of HCC treated with lenvatinib. For the majority of patients,11 (73.3%) patients received lenvatinib as first-line therapy.
 Results. The median progression-free survival was 11.2 months for the entire observation group. In the first line of therapy, the PFS result was the highest and amounted to 12.3 months. The median dose received by patients was 10.9 mg. The level of disease control was 86.6%. The most clinically significant adverse events were grade 2 neutropenia, grade 2 thrombocytopenia, grade 2 asthenia, grade 23 hypertension. Lenvatinib had a manageable safety profile.
 Conclusion. The performed analysis confirms the data of the REFLECT study on the efficacy of lenvatinib both in healthy patients and in patients with a spectrum of comorbidities with significant (more than 50% of the liver parenchyma) liver damage.