TY - JOUR T1 - Rechallenge With Lenvatinib After Atezolizumab Plus Bevacizumab Treatment for Hepatocellular Carcinoma JF - Anticancer Research JO - Anticancer Res SP - 5479 LP - 5486 DO - 10.21873/anticanres.16053 VL - 42 IS - 11 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 Y1 - 2022/11/01 UR - http://ar.iiarjournals.org/content/42/11/5479.abstract N2 - 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. ER -