Background:Lenvatinib is used for unresectable hepatocellular carcinoma(u-HCC)as first-line,as well as second-and third-line therapy in Japan.We evaluated the therapeutic efficacy of newly developed ramucirumab when g...Background:Lenvatinib is used for unresectable hepatocellular carcinoma(u-HCC)as first-line,as well as second-and third-line therapy in Japan.We evaluated the therapeutic efficacy of newly developed ramucirumab when given after lenvatinib for post-progression treatment.Methods:Of 385 patients with u-HCC and treated with lenvatinib at 16 different institutions in Japan between May 2018 and January 2020,28 who received ramucirumab as the next treatment were enrolled and therapeutic responses were evaluated in a retrospective manner.Results:The median age of the 28 patients given ramucirumab was 70 years and the median albumin-bilirubin score was-2.19.Of the 28 patients,23 were male,21 were classified as Child-Pugh A and 7 as Child-Pugh B,and 25 were Barcelona Clinic Liver Cancer Stage C.Ramucirumab was given as second-line therapy in 14,third-line in 9,and fourth-line in 5.Therapeutic response was obtained in only 26 patients;the objective response rate was 3.8%(1/26)and the disease-control rate was 42.3%(11/26),with a median period to progression of 2.0 months.The reasons for discontinuation of ramucirumab were progression of disease in 16 and Grade 3 adverse events(gastrointestinal bleeding,ascites)in 2.Conclusions:The anticipated therapeutic efficacy of ramucirumab for post-progression treatment following lenvatinib was not seen in our early experience.展开更多
Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of...Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of this study was to examine the risk of HCC recurrence after DAA therapy.Methods:We conducted a retrospective cohort study of 312 consecutive patients with HCV-related HCC who received DAA therapy in participating institutions between September 2014 and July 2016.All patients received curative ;hepatectomy or radio-frequency ablation.We calculated the annual incidence of HCC recurrence after DAA therapy and identified the risk factors for HCC recurrence using Cox regression models.Results:The median age was 74 years old,and a sustained virological response was achieved by 288 patients.The 3-year-overall survival rate was 95.4%in a median follow-up period of 855 days.HCC recurred in 135 patients.The 1-,2-and 3-year recurrence rates were 18.3%,38.8%and 55.4%,respectively.A multivariate analysis revealed that the following factors were associated with HCC recurrence:multiple tumors at the first HCC treatment[hazard ratio(HR)=2.21;95%CI:1.41-3.49],a history of multiple treatments for HCC(HR=1.97;95%CI:1.28-3.02),andα-fetoprotein(AFP-L3)≥10%at the initiation of DAA therapy(HR=4.74;95%CI:2.10-10.7).Conclusion:Among patients treated with DAAs after the curative treatment of HCC,multiple tumors at the first HCC treatment,multiple prior HCC treatments and a high AFP-L3 level before DAA therapy were associated with recurrence,and the rate of recurrence was comparable to that before the DAA era.展开更多
文摘Background:Lenvatinib is used for unresectable hepatocellular carcinoma(u-HCC)as first-line,as well as second-and third-line therapy in Japan.We evaluated the therapeutic efficacy of newly developed ramucirumab when given after lenvatinib for post-progression treatment.Methods:Of 385 patients with u-HCC and treated with lenvatinib at 16 different institutions in Japan between May 2018 and January 2020,28 who received ramucirumab as the next treatment were enrolled and therapeutic responses were evaluated in a retrospective manner.Results:The median age of the 28 patients given ramucirumab was 70 years and the median albumin-bilirubin score was-2.19.Of the 28 patients,23 were male,21 were classified as Child-Pugh A and 7 as Child-Pugh B,and 25 were Barcelona Clinic Liver Cancer Stage C.Ramucirumab was given as second-line therapy in 14,third-line in 9,and fourth-line in 5.Therapeutic response was obtained in only 26 patients;the objective response rate was 3.8%(1/26)and the disease-control rate was 42.3%(11/26),with a median period to progression of 2.0 months.The reasons for discontinuation of ramucirumab were progression of disease in 16 and Grade 3 adverse events(gastrointestinal bleeding,ascites)in 2.Conclusions:The anticipated therapeutic efficacy of ramucirumab for post-progression treatment following lenvatinib was not seen in our early experience.
文摘Aim:The increased risk of hepatocellular carcinoma(HCC)recurrence in hepatitis C virus(HCV)-infected patients treated with direct-acting antivirals(DAAs)after curative treatment for HCC is controversial.The purpose of this study was to examine the risk of HCC recurrence after DAA therapy.Methods:We conducted a retrospective cohort study of 312 consecutive patients with HCV-related HCC who received DAA therapy in participating institutions between September 2014 and July 2016.All patients received curative ;hepatectomy or radio-frequency ablation.We calculated the annual incidence of HCC recurrence after DAA therapy and identified the risk factors for HCC recurrence using Cox regression models.Results:The median age was 74 years old,and a sustained virological response was achieved by 288 patients.The 3-year-overall survival rate was 95.4%in a median follow-up period of 855 days.HCC recurred in 135 patients.The 1-,2-and 3-year recurrence rates were 18.3%,38.8%and 55.4%,respectively.A multivariate analysis revealed that the following factors were associated with HCC recurrence:multiple tumors at the first HCC treatment[hazard ratio(HR)=2.21;95%CI:1.41-3.49],a history of multiple treatments for HCC(HR=1.97;95%CI:1.28-3.02),andα-fetoprotein(AFP-L3)≥10%at the initiation of DAA therapy(HR=4.74;95%CI:2.10-10.7).Conclusion:Among patients treated with DAAs after the curative treatment of HCC,multiple tumors at the first HCC treatment,multiple prior HCC treatments and a high AFP-L3 level before DAA therapy were associated with recurrence,and the rate of recurrence was comparable to that before the DAA era.
