Effect of Nutritional Index on Lenvatinib Treatment Retention Rates in Unresectable Hepatocellular Carcinoma.

Background/aim: Several studies have reported the association between lenvatinib (LEN) treatment and nutritional indices. However, no study has used multiple nutritional indices or reported their changes during treatment. This study aimed to clarify the association between LEN treatment and nutritional status.

Patients and methods: Patients with hepatocellular carcinoma (n=103) treated with LEN were divided into two groups, namely normal and poor nutritional groups, using the Controlling Nutritional Status (CONUT) score, Onodera-Prognostic Nutritional Index (O-PNI), modified Glasgow Prognostic Score (mGPS), and Geriatric Nutritional Risk Index (GNRI). Treatment retention rates were then compared between the two groups. Additionally, changes in nutritional indices from the start of treatment to the end of the observation period or treatment were analyzed to determine their relationship with treatment continuation.

Results: Patients with normal nutrition according to the CONUT score, O-PNI, mGPS, and GNRI had a significantly higher rate of treatment retention than those with poor nutrition. Furthermore, both a normal CONUT score and mGPS indicated a lower likelihood of discontinuation due to adverse events. Patients in whom treatment was continued were significantly more likely to maintain or improve their CONUT score.

Conclusion: Maintaining or restoring a normal nutritional status is important to ensure continued treatment with LEN. Both the combination of the CONUT score and mGPS at the start of LEN treatment, and the CONUT score during treatment, are useful indicators of nutritional status.