TREATMENT OUTCOMES OF INTERMEDIATE-STAGE HEPATOCELLULAR CARCINOMA WITH LENVATINIB COMBINED WITH TRANSARTERIAL CHEMOEMBOLIZATION (TACE) AT HANOI MEDICAL UNIVERSITY HOSPITAL
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Abstract
Background: Hepatocellular carcinoma (HCC) represents a major health burden in Vietnam and is associated with high mortality. In patients with intermediate-stage disease (Barcelona Clinic Liver Cancer [BCLC] stage B) and high tumor burden, transarterial chemoembolization (TACE) alone has limitations due to post-intervention tumor revascularization and cumulative deterioration of liver function.
Objective: To evaluate the efficacy and safety of combined lenvatinib and TACE in patients with intermediate-stage HCC, based on tumor response according to modified Response Evaluation Criteria in Solid Tumors (mRECIST), progression-free survival (PFS), and treatment-related adverse events.
Methods: This descriptive study included 40 patients treated at Hanoi Medical University Hospital. Lenvatinib was administered as a lead-in therapy for 14–21 days before the first TACE session, followed by repeat TACE as clinically indicated. Tumor response was assessed using mRECIST through serial computed tomography (CT) or magnetic resonance imaging (MRI). The primary outcomes included objective response rate (ORR), disease control rate (DCR), PFS, and adverse events graded according to the Common Terminology Criteria for Adverse Events, version 5.0 (CTCAE v5.0).
Results: The ORR was 62.5%, including a complete response rate of 7.5% and a partial response rate of 55.0%; the DCR was 90.0%. The median PFS was 11.6 months (95% confidence interval [CI], 7.8–15.5). The combination regimen was generally well tolerated, with most adverse events being grade 1–2. The most common adverse events were fatigue (45.0%) and hypertension (42.5%), while grade ≥3 toxicities were uncommon.
Conclusion: The combination of lenvatinib and TACE demonstrated favorable tumor control and an acceptable safety profile in patients with intermediate-stage HCC. This treatment strategy may represent a feasible therapeutic option for patients with a high tumor burden.
Keywords
Hepatocellular carcinoma, Lenvatinib, transarterial chemoembolization, combination therapy
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References
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