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Second-line therapy for advanced hepatocellular carcinoma with regorafenib or cabozantinib:Multicenter French clinical experience in real-life after matching

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World Journal of Gastrointestinal Oncology 2022年第8期14卷 1510-1527页

作者： Xavier Adhoute Marie De Matharel Laurent Mineur Guillaume Pénaranda Dann Ouizeman clemence toullec Albert Tran Paul Castellani Armelle Rollet Valérie Oules HervéPerrier Si Nafa Si Ahmed Marc Bourliere Rodolphe Anty Department of Gastroenterology and Hepatology Hôpital Saint-JosephMarseille 13000France Department of Gastroenterology and Hepatology Hôpital Universitaire de l’ArchetNice 06000France Department of Oncology Institut Sainte-CatherineAvignon 84000France Department of Biostatistics AlphaBio LaboratoryMarseille 13000France

BACKGROUND Starting a second-line systemic treatment for hepatocellular carcinoma(HCC)is a common *** only therapeutic options in France are two broadspectrum tyrosine kinase inhibitors(TKIs),regorafenib(REG)and cabozantinib(CBZ),but no comparative real-life studies are *** To evaluate the progression-free survival(PFS)of patients treated with REG or CBZ,we investigated the disease control rate(DCR),overall survival(OS),and safety of both *** identify the variables associated with disease progression over *** A retrospective multicenter study was performed on the clinical data of patients attending one of three referral centers(Avignon,Marseille,and Nice)between January 2017 and March 2021 using propensity score *** and OS were assessed using the Kaplan-Meier *** analysis(MA)of progression risk factors over time was performed in matched-pair *** Fifty-eight patients 68(62-74)years old with HCC,Barcelona clinic liver cancer(BCLC)B/C(86%),Child-Pugh(CP)-A/B(24%)received REG for 3.4(1.4-10.5)mo as second-line *** patients 68(60-73)years,BCLC B/C(75%),CP-A/B(25%)received CBZ for 3.7(1.8-4.9)mo after first-line treatment with sorafenib[3(2-4)(CBZ)vs 4(2.9-11.8)mo(REG),P=0.0226].Twenty percent of patients received third-line *** matching,PFS and DCR were not significantly different after a median follow-up of 6.2(2.7-11.7)mo(REG)vs 5.2(4-7.2)mo(CBZ),P=*** was no difference in grade 3/4 toxicities,dose reductions,or *** OS of CP-A patients was 8.3(5.2-24.8)vs 4.9(1.6-11.7)mo(CP-B),P=*** MA of risk factors for progression over time identified C-reactive protein(CRP)>10 mg/L,neutrophil-to-lymphocyte ratio(NLR)>3,and aspartate aminotransferase(AST)>45 IU as predictive *** This multicenter indirect comparative study found no significant difference in PFS between REG and CBZ as second-line therapy for advanced *** levels of inflam

关键词： Hepatocellular carcinoma Regorafenib Cabozantinib C-reactive protein Neutrophillymphocyte ratio

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