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Sorafenib versus nivolumab after lenvatinib treatment failure in patients with advanced hepatocellular carcinoma

Authors
 Yuna Kim  ;  Jae Seung Lee  ;  Hye Won Lee  ;  Beom Kyung Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Myung Ji Goh  ;  Wonseok Kang  ;  Seung Up Kim  
Citation
 EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, Vol.35(2) : 191-197, 2023-02 
Journal Title
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY
ISSN
 0954-691X 
Issue Date
2023-02
MeSH
Antineoplastic Agents* / adverse effects ; Carcinoma, Hepatocellular* / pathology ; Humans ; Liver Neoplasms* / pathology ; Middle Aged ; Nivolumab / adverse effects ; Phenylurea Compounds / adverse effects ; Sorafenib / adverse effects ; Treatment Failure
Abstract
Background and aim: An optimal sequential anti-hepatocellular carcinoma (HCC) agent that can be used after failed lenvatinib treatment has not been established. Here, we compared the outcomes of sorafenib and nivolumab as second-line agents after failed lenvatinib treatment in patients with advanced HCC.

Methods: Patients with advanced HCC who had received sorafenib or nivolumab as second-line agents after failed lenvatinib treatment were recruited from two Korean tertiary institutions between November 2018 and June 2020.

Results: The median age of the 60 participants (52 treated with sorafenib and eight treated with nivolumab) at baseline was 56.8 years. The demographic, laboratory and tumor variables, as well as lenvatinib treatment duration, were similar between the two groups. The median durations of sorafenib and nivolumab treatment were 1.2 and 2.6 months, respectively ( P = 0.164). Twenty-four (40.0%) patients died during the follow-up period (median, 15.8 months). The median overall survival (OS) of the study population was 5.8 months. The median OS of patients treated with sorafenib was significantly longer than the median OS of patients treated with nivolumab (8.7 vs. 3.0 months; P = 0.046). Sorafenib treatment (vs. nivolumab) was independently associated with a lower risk of mortality (hazard ratio = 0.194; 95% confidence interval, 0.053-0.708; P = 0.013). Worse Eastern Cooperative Oncology Group performance status, larger maximal tumor size, lymph node metastases and higher total bilirubin levels were independently associated with increased mortality risk (all P < 0.05).

Conclusions: Lenvatinib-sorafenib sequential treatment resulted in significantly better survival did than lenvatinib-nivolumab sequential treatment in patients with advanced HCC. Larger studies are needed to validate our results.
Full Text
https://journals.lww.com/eurojgh/Fulltext/2023/02000/Sorafenib_versus_nivolumab_after_lenvatinib.7.aspx
DOI
10.1097/MEG.0000000000002466
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Kim, Yuna(김윤아)
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/193516
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