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Efficacy and safety of lenvatinib for unresectable,advanced hepatocellular carcinoma in a real-world setting
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摘要: <正>肝细胞癌(HCC)是常见的恶性肿瘤,在我国其发病率和死亡率分别位列各类恶性肿瘤的第四位和第二位,由于HCC起病隐匿,大多数患者发现时已是晚期。在之前很长一段时间里,索拉非尼是唯一一个被推荐用于晚期HCC系统治疗的一线药物,2018年公布的REFLECT研究结果[1]显示,仑伐替尼一线治疗晚期HCC的总生存期(overall survival,OS)不劣于索拉非尼,亚组分析进一步揭示,对于中国人群仑伐替尼无论是近期客观缓解率(objective response rate,ORR)还是远期OS均优于索拉非尼。目前,包括中国临床肿瘤学会(CSCO)在内的多个医学专业机构颁布的临床指南[2]均将仑伐替尼列为晚期HCC的一线治疗药物。然而,在REFLECT研究的入组标准中,
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Key words:
- carcinoma,hepatocellular /
- lenvatinib /
- treatment outcome
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[1] KUDO M,FINN RS,QIN S,et al. Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma:A randomised phase 3 non-inferiority trial[J]. Lancet,2018,391(10126):1163-1173. [2] Guideline Working Committee of Chinese Society of Clinical Oncology. Guidelines of Chinese society of Clinical Oncology(CSCO)hepatocellular carcinoma(2018，Ⅵ)[M]. Beijing:People’s Medical Publishing House(PMPH),2018.(in Chinese)中国临床肿瘤学会指南工作委员会．中国临床肿瘤学会原发性肝癌诊疗指南(2018. V1)[M]．北京:人民卫生出版社，2018. [3] IKEDA M,OKUSAKA T,MITSUNAGA S,et al. Safety and pharmacokinetics of lenvatinib in patients with advanced hepatocellular carcinoma[J]. Clin Cancer Res,2016,22(6):1385-1394. [4] BERTUCCIO P,TURATI F,CARIOLI G,et al. Global trends and predictions in hepatocellular carcinoma mortality[J]. J Hepatol,2017,67(2):302-309. [5] OMATA M,CHENG AL,KOKUDO N,et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma:A 2017 update[J]. Hepatol Int,2017,11(4):317-370. [6] CHANG QQ,PENG Y,WANG GJ,et al. Clinical research progress of small molecule tyrosine kinase inhibitors as antihepatocell carcinoma agents[J]. Chin J Clin Pharmacol Ther,2019,24(8):948-956.(in Chinese)常青青，彭英，王广基，等．抗肝癌小分子酪氨酸激酶抑制剂的临床研究进展[J]．中国临床药理学与治疗学，2019,24(8):948-956. [7] OBI S,SATO T,SATO S,et al. The efficacy and safety of lenvatinib for advanced hepatocellular carcinoma in a real-world setting[J]. Hepatol Int,2019,13(2):199-204. [8] YU JI,PARK HC. Radiotherapy as valid modality for hepatocellular carcinoma with portal vein tumor thrombosis[J]. World J Gastroenterol,2016,22(30):6851-6863. [9] SCHLUMBERGER M,TAHARA M,WIRTH LJ,et al. Lenvatinib versus placebo in radioiodine-refractory thyroid cancer[J]. N Engl J Med,2015,372(7):621-630. [10] IKEDA K,KUDO M,KAWAZOE S,et al. Phase 2 study of lenvatinib in patients with advanced hepatocellular carcinoma[J]. J Gastroenterol,2017,52(4):512-519. -
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