期刊
INTERNAL MEDICINE
卷 60, 期 3, 页码 345-351出版社
JAPAN SOC INTERNAL MEDICINE
DOI: 10.2169/internalmedicine.5185-20
关键词
hepatocellular carcinoma; high malignant potential; lenvatinib; liver function; ramucirumab
资金
- Ministry of Health, Labor and Welfare in Japan
- Japan Agency for Medical Research and Development
- Okinaka Memorial Institute for Medical Research
- Japanese Ministry of Health, Labor and Welfare
This study assessed the early anti-tumor response to ramucirumab (RAM) as a second-line treatment for advanced unresectable hepatocellular carcinoma (uHCC) after lenvatinib (LEN) treatment. Results suggest that RAM may have the potential to suppress uHCC progression and maintain liver function during treatment, supporting the importance of evaluating alpha-fetoprotein (AFP) trends for predicting RAM effectiveness.
Objective A survival benefit was demonstrated for ramucirumab (RAM) in patients with unresectable hepatocellular carcinoma (uHCC) and alpha-fetoprotein (AFP) concentrations >= 400 ng/mL who had previously received sorafenib (SOR). However, it is unclear whether RAM has a similar efficacy in patients with uHCC that progresses after lem atinib (LEN) treatment. This study aimed to evaluate the early anti-tumor response to RAM as a second-line treatment for advanced uHCC after LEN treatment. Methods We retrospectively assessed the efficacy and safety of RAM at 6 weeks after initiation. The therapeutic effects were evaluated according to the Response Evaluation Criteria in Solid Tumors version 1.1. Patients We evaluated 7 patients with uHCC who received RAM as a second- or third-line treatment after LEN failure. Results The disease control rate (DCR) was 28.6% (2 of 7 patients). After the initiation of RAM, a rapid disease progression resulted in 1 patient death after 19 days. The median progression-free survival (PFS) was 41 days. There were no grade 3 or 4 treatment-related adverse events. At 6 weeks, there was no deterioration in the modified albumin-bilirubin (mALBI) grade. In patients with an imaging response of stable disease (SD), the rate of AFP production decreased from the baseline. Conclusion RAM may have a therapeutic potential for the suppression of uHCC progression in patients previously treated with LEN, as well as for maintaining the liver function during treatment. Evaluating the AFP trends may therefore be useful for predicting RAM effectiveness.
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