دورية أكاديمية

Association between treatment‐emergent hypertension and survival with lenvatinib treatment for patients with hepatocellular carcinoma in the REFLECT study.

التفاصيل البيبلوغرافية
العنوان: Association between treatment‐emergent hypertension and survival with lenvatinib treatment for patients with hepatocellular carcinoma in the REFLECT study.
المؤلفون: Piscaglia, Fabio, Ikeda, Kenji, Cheng, Ann‐Lii, Kudo, Masatoshi, Ikeda, Masafumi, Breder, Valery, Ryoo, Baek‐Yeol, Mody, Kalgi, Ren, Min, Ramji, Zahra, Sung, Max W.
المصدر: Cancer (0008543X); Apr2024, Vol. 130 Issue 8, p1281-1291, 11p
مصطلحات موضوعية: HEPATOCELLULAR carcinoma, PROTEIN-tyrosine kinase inhibitors, HYPERTENSION, OVERALL survival, PROGRESSION-free survival
مستخلص: Background: Lenvatinib is approved as a first‐line treatment for patients with unresectable and/or recurrent hepatocellular carcinoma (HCC). Lenvatinib achieved promising clinical benefits in REFLECT but was associated with clinically significant treatment‐emergent hypertension (CSTE‐HTN, a grouped term), a common class effect of tyrosine kinase inhibitors. This post hoc analysis assessed the impact of CSTE‐HTN on the efficacy and safety of lenvatinib in HCC. Methods: Patients from REFLECT who received lenvatinib (n = 476) were stratified according to CSTE‐HTN. Tumors were assessed by mRECIST. Overall survival (OS) and progression‐free survival (PFS) were evaluated using landmark analyses at 4 and 8 weeks. Results: A total of 212 patients in the lenvatinib arm developed CSTE‐HTN, and 264 did not. CSTE‐HTN first occurred at 3.7 weeks (median); the worst grade CSTE‐HTN occurred at 4.1 weeks (median). No patients had life‐threatening CSTE‐HTN and/or died due to CSTE‐HTN. Median OS was numerically longer in patients with versus without CSTE‐HTN (at 4 weeks: 16.3 vs. 11.6 months; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.621–1.004; at 8 weeks: 13.5 vs. 11.6 months; HR, 0.87; 95% CI, 0.696–1.089). Median PFS was similar between patients with and without CSTE‐HTN (at 4 weeks: 6.6 vs. 6.4 months; HR, 0.887; 95% CI, 0.680–1.157; at 8 weeks: 5.7 vs. 6.4 months; HR, 1.09; 95% CI, 0.84–1.41). Objective response rate was numerically higher in patients with (48.6%) versus without CSTE‐HTN (34.5%). Conclusions: In this retrospective analysis, CSTE‐HTN was associated with improved OS but not PFS. CSTE‐HTN did not impair the outcomes of patients with HCC treated with lenvatinib when detected early and managed appropriately. Clinically significant treatment‐emergent hypertension (CSTE‐HTN) in patients with hepatocellular carcinoma who are treated with lenvatinib does not negatively impact outcomes when CSTE‐HTN is detected early and managed appropriately with dedicated medication and lenvatinib dose modifications. [ABSTRACT FROM AUTHOR]
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قاعدة البيانات: Complementary Index
الوصف
تدمد:0008543X
DOI:10.1002/cncr.35185