PT  - JOURNAL ARTICLE
AU  - SHOHEI KOMATSU
AU  - YOSHIHIKO YANO
AU  - MASAHIRO KIDO
AU  - KAORI KURAMITSU
AU  - HIDETOSHI GON
AU  - KENJI FUKUSHIMA
AU  - TAKESHI URADE
AU  - SHINICHI SO
AU  - ATSUSHI YAMAMOTO
AU  - TADAHIRO GOTO
AU  - HIROAKI YANAGIMOTO
AU  - HIROCHIKA TOYAMA
AU  - YOSHIHIDE UEDA
AU  - YUZO KODAMA
AU  - TAKUMI FUKUMOTO
TI  - Rechallenge With Lenvatinib After Atezolizumab Plus Bevacizumab Treatment for Hepatocellular Carcinoma
AID  - 10.21873/anticanres.16053
DP  - 2022 Nov 01
TA  - Anticancer Research
PG  - 5479--5486
VI  - 42
IP  - 11
4099  - http://ar.iiarjournals.org/content/42/11/5479.short
4100  - http://ar.iiarjournals.org/content/42/11/5479.full
SO  - Anticancer Res2022 Nov 01; 42
AB  - Background/Aim: Atezolizumab plus bevacizumab and lenvatinib are the key drugs in the current systemic chemotherapeutic regimen for hepatocellular carcinoma (HCC). Studies have reported the potential effectiveness of lenvatinib introduction after an atezolizumab plus bevacizumab treatment; however, the therapeutic effectiveness of a lenvatinib rechallenge after an atezolizumab plus bevacizumab treatment remains unclear. Patients and Methods: Thirteen consecutive patients who were rechallenged with lenvatinib after clinical failure following treatments with lenvatinib and atezolizumab plus bevacizumab were included. A comparative study was conducted on the duration and treatment efficacy of the first and second lenvatinib treatments and on the pre- and post-treatment liver function. Results: The median ratios of the 1-month post-treatment alpha-fetoprotein (AFP) levels to the pretreatment AFP levels were 0.750 and 0.667 for the first and second lenvatinib treatments, respectively, without significant difference (p=0.9327). Meanwhile, the median ratios of the 1-month post-treatment albumin-bilirubin (ALBI) scores to the pretreatment ALBI scores were 1.063 and 0.827 for the first and second lenvatinib treatments, respectively, with significant difference (p=0.015). The median duration of the second lenvatinib treatment was significantly shorter than that of the first lenvatinib treatment [2.8 months (range=0.9-4.7 months) vs. 8.7 months (range=3.1-29.7 months)]. Conclusion: Lenvatinib re-administration after atezolizumab plus bevacizumab treatment can act as a double-edged sword, as it exerts an anti-tumor effect while being associated with potential liver function deterioration. However, this treatment sequence can be useful, and requires careful monitoring of the transitions in the liver function and the patient’s performance status.