Multicenter Phase II Trial of Lenvatinib plus Hepatic Intra-Arterial Infusion Chemotherapy with Cisplatin for Advanced Hepatocellular Carcinoma: LEOPARD.

IF 11.6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Liver Cancer Pub Date : 2023-07-07 eCollection Date: 2024-04-01 DOI:10.1159/000531820
Masafumi Ikeda, Tatsuya Yamashita, Sadahisa Ogasawara, Masatoshi Kudo, Yoshitaka Inaba, Manabu Morimoto, Kaoru Tsuchiya, Satoshi Shimizu, Yasushi Kojima, Atsushi Hiraoka, Kazuhiro Nouso, Hiroshi Aikata, Kazushi Numata, Tosiya Sato, Takuji Okusaka, Junji Furuse
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引用次数: 0

Abstract

Introduction: Hepatic arterial infusion chemotherapy (HAIC) with cisplatin and lenvatinib exhibits strong antitumor effects against advanced hepatocellular carcinoma (HCC). Higher antitumor activity is expected for the combination treatment. The aim of this trial was to evaluate the efficacy and safety of lenvatinib in combination with HAIC using cisplatin in patients with advanced HCC.

Methods: In this multicenter, open-labeled, single-arm, phase II trial, patients with advanced HCC categorized as Child-Pugh class A with no prior history of systemic therapy were enrolled. Patients received lenvatinib plus HAIC with cisplatin (lenvatinib: 12 mg once daily for patients ≥60 kg, 8 mg once daily for patients <60 kg; HAIC with cisplatin: 65 mg/m2, day 1, every 4-6 weeks, maximum of six cycles). The primary endpoint was the objective response rate (ORR) assessed using modified RECIST by the Independent Review Committee. The secondary endpoints were the ORR assessed using RECIST v1.1, progression-free survival, overall survival, and frequency of adverse events associated with the treatment.

Results: A total of 36 patients were enrolled between September 2018 and March 2020. In the 34 evaluable patients, the ORR assessed by the Independent Review Committee using modified RECIST and RECIST v1.1 were 64.7% (95% confidence interval [CI]: 46.5-80.3%) and 45.7% (95% CI: 28.8-63.4%), respectively. The median progression-free survival and overall survival were 6.3 months (95% CI: 5.1-7.9 months) and 17.2 months (95% CI: 10.9 - not available, months), respectively. The main grade 3-4 adverse events were increased aspartate aminotransferase (34%), leukopenia (22%), increased alanine aminotransferase (19%), and hypertension (11%).

Conclusion: Lenvatinib plus HAIC with cisplatin yielded a favorable ORR and overall survival and was well tolerated in patients with advanced HCC. Further evaluation of this regimen in a phase III trial is warranted.

乐伐替尼联合顺铂肝动脉内灌注化疗治疗晚期肝细胞癌的多中心 II 期试验:LEOPARD.
简介顺铂和来伐替尼的肝动脉灌注化疗(HAIC)对晚期肝细胞癌(HCC)有很强的抗肿瘤作用。预计联合治疗的抗肿瘤活性更高。本试验旨在评估来伐替尼与顺铂HAIC联合治疗晚期HCC患者的有效性和安全性:在这项多中心、开放标签、单臂II期试验中,纳入了Child-Pugh分类为A级、既往无系统治疗史的晚期HCC患者。患者接受来伐替尼+HAIC联合顺铂治疗(来伐替尼:体重≥60公斤的患者为12毫克,每天1次;体重≥60公斤的患者为8毫克,每天1次,每4-6周为1天,最多6个周期)。主要终点是客观反应率(ORR),由独立审查委员会使用修改后的 RECIST 进行评估。次要终点是使用 RECIST v1.1 评估的客观反应率、无进展生存期、总生存期以及与治疗相关的不良反应频率:2018年9月至2020年3月期间,共有36名患者入组。在34名可评估患者中,独立审查委员会使用改良RECIST和RECIST v1.1评估的ORR分别为64.7%(95%置信区间[CI]:46.5-80.3%)和45.7%(95% CI:28.8-63.4%)。中位无进展生存期和总生存期分别为6.3个月(95% CI:5.1-7.9个月)和17.2个月(95% CI:10.9-不详)。3-4级不良反应主要为天冬氨酸氨基转移酶升高(34%)、白细胞减少(22%)、丙氨酸氨基转移酶升高(19%)和高血压(11%):结论:乐伐替尼联合HAIC与顺铂治疗晚期HCC患者可获得较好的ORR和总生存期,且耐受性良好。有必要在III期试验中进一步评估该方案。
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来源期刊
Liver Cancer
Liver Cancer Medicine-Oncology
CiteScore
20.80
自引率
7.20%
发文量
53
审稿时长
16 weeks
期刊介绍: Liver Cancer is a journal that serves the international community of researchers and clinicians by providing a platform for research results related to the causes, mechanisms, and therapy of liver cancer. It focuses on molecular carcinogenesis, prevention, surveillance, diagnosis, and treatment, including molecular targeted therapy. The journal publishes clinical and translational research in the field of liver cancer in both humans and experimental models. It publishes original and review articles and has an Impact Factor of 13.8. The journal is indexed and abstracted in various platforms including PubMed, PubMed Central, Web of Science, Science Citation Index, Science Citation Index Expanded, Google Scholar, DOAJ, Chemical Abstracts Service, Scopus, Embase, Pathway Studio, and WorldCat.
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