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Prospect of lenvatinib for unresectable hepatocellular carcinoma in the new era of systemic chemotherapy

World Journal of Gastrointestinal Oncology 2021年第12期13卷 2076-2087页

作者： Takuya Sho Kenichi Morikawa Akinori Kubo Yoshimasa Tokuchi Takashi Kitagataya Ren Yamada Taku Shigesawa Mugumi Kimura Masato Nakai Goki Suda Mitsuteru Natsuizaka Koji Ogawa Naoya Sakamoto Department of Gastroenterology and Hepatology Hokkaido University Faculty of Medicine and Graduate School of MedicineSapporo 060-8638HokkaidoJapan

The phase III clinical trial of the novel molecular targeted agent(MTA)lenvatinib for patients with advanced hepatocellular carcinoma(HCC)(REFLECT trial)found that lenvatinib was non-inferior to sorafenib in overall ***,the efficacy of multiple MTAs,including lenvatinib,in practice has been reported,and therapeutic strategies for barcelona clinic liver cancer(BCLC)intermediate stage HCC are undergoing major *** on these results,lenvatinib could be recommended for patients with transcatheter arterial chemoembolization(TACE)-refractory,ALBI grade 1,within the up-to-seven criteria in the BCLC intermediate *** provides a more favorable outcome than TACE,even in cases with large or multinodular HCC beyond the up-to-seven criteria with Child-Pugh grade *** patients meet the definitions of TACE-refractory or TACE-unsuitable,switching to systemic chemotherapy,including lenvatinib,is for favorable for preserving liver *** initial treatment,including MTA,has a significant therapeutic effect and downstaging of HCC is obtained,additional TACE or surgical resection should be *** also has a therapeutic effect for poorly differentiated type and non-simple nodular type HCC thanks to the survival-prolonging effect of this ***,a significant therapeutic effect is expected in tumors with more than 50%liver involvement or main portal vein invasion,which have traditionally been considered to have a poor prognosis in *** suggests that at the start of lenvatinib treatment,HCC patients with ALBI grade 1 may be able to maintain liver functional reserve.

关键词： Hepatocellular carcinoma Lenvatinib Molecular targeted agent TACE refractory TACE-unsuitable barcelona clinic liver cancer intermediate stage

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