{"title":"Lenvatinib给药前蛋白尿对Atezolizumab -贝伐单抗联合治疗后治疗反应的影响。","authors":"Hironori Ochi, Masayuki Kurosaki, Takaaki Tanaka, Nobuharu Tamaki, Kaoru Tsuchiya, Yutaka Yasui, Hiroyuki Marusawa, Toshifumi Tada, Shinichiro Nakamura, Takehiro Akahane, Eisuke Okamoto, Haruhiko Kobashi, Hirotaka Arai, Michiko Nonogi, Namiki Izumi","doi":"10.1002/jgh3.70098","DOIUrl":null,"url":null,"abstract":"<p><strong>Aim: </strong>We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.</p><p><strong>Methods: </strong>We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, <i>n</i> = 13) and non-severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, <i>n</i> = 51).</p><p><strong>Results: </strong>In the entire cohort, the modified albumin-bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3-18.4) and 5.5 (95% CI, 3.6-7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (<i>n</i> = 13) and 17.6% and 64.7% for group B (<i>n</i> = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (<i>p</i> = 0.120).</p><p><strong>Conclusions: </strong>Severe proteinuria before lenvatinib as a second-line therapy after atezolizumab-bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.</p>","PeriodicalId":45861,"journal":{"name":"JGH Open","volume":"9 1","pages":"e70098"},"PeriodicalIF":1.7000,"publicationDate":"2025-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743979/pdf/","citationCount":"0","resultStr":"{\"title\":\"Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy.\",\"authors\":\"Hironori Ochi, Masayuki Kurosaki, Takaaki Tanaka, Nobuharu Tamaki, Kaoru Tsuchiya, Yutaka Yasui, Hiroyuki Marusawa, Toshifumi Tada, Shinichiro Nakamura, Takehiro Akahane, Eisuke Okamoto, Haruhiko Kobashi, Hirotaka Arai, Michiko Nonogi, Namiki Izumi\",\"doi\":\"10.1002/jgh3.70098\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aim: </strong>We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.</p><p><strong>Methods: </strong>We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, <i>n</i> = 13) and non-severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, <i>n</i> = 51).</p><p><strong>Results: </strong>In the entire cohort, the modified albumin-bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3-18.4) and 5.5 (95% CI, 3.6-7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (<i>n</i> = 13) and 17.6% and 64.7% for group B (<i>n</i> = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (<i>p</i> = 0.120).</p><p><strong>Conclusions: </strong>Severe proteinuria before lenvatinib as a second-line therapy after atezolizumab-bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.</p>\",\"PeriodicalId\":45861,\"journal\":{\"name\":\"JGH Open\",\"volume\":\"9 1\",\"pages\":\"e70098\"},\"PeriodicalIF\":1.7000,\"publicationDate\":\"2025-01-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11743979/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JGH Open\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/jgh3.70098\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JGH Open","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/jgh3.70098","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy.
Aim: We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.
Methods: We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, n = 13) and non-severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, n = 51).
Results: In the entire cohort, the modified albumin-bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3-18.4) and 5.5 (95% CI, 3.6-7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (n = 13) and 17.6% and 64.7% for group B (n = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (p = 0.120).
Conclusions: Severe proteinuria before lenvatinib as a second-line therapy after atezolizumab-bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.
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