P-118 Tepotinib (MSC2156119J) monotherapy in patients with MET-positive advanced hepatocellular carcinoma with Child-Pugh Class A liver function who have failed sorafenib treatment: phase Ib/II trial

Background: Although a strong antitumor effect of lenvatinib (LEN) has been noted for patients with unresectable hepatocellular carcinoma (HCC), there are still no reports on the prognosis for patients with disease progression after first-line LEN therapy. Methods: Patients (n = 141) with unresectable HCC, Child-Pugh class A liver function, and an Eastern Cooperative Oncology Group performance status (ECOG-PS) of 0 or 1 who were treated with LEN from March 2018 to December 2019 were enrolled. Results: One hundred and five patients were treated with LEN as first-line therapy, 53 of whom had progressive disease (PD) at the radiological evaluation. Among the 53 patients with PD, there were 27 candidates for second-line therapy, who had Child-Pugh class A liver function and an ECOG-PS of 0 or 1 at progression. After progression on first-line LEN, 28 patients were treated with a molecular targeted agent (MTA) as second-line therapy (sorafenib: n = 26; ramucirumab: n = 2). Multivariate analysis identified modified albumin-bilirubin grade 1 or 2a at LEN initiation (odds ratio 5.18, 95% confidence interval [CI] 1.465–18.31, p = 0.011) as a significant and independent factor for candidates. The median post-progression survival after PD on first-line LEN was 8.3 months. Cox hazard multivariate analysis showed that a low alpha-fetoprotein level (<400 ng/mL; hazard ratio [HR] 0.297, 95% CI 0.099–0.886, p = 0.003), a relative tumor volume <50% at the time of progression (HR 0.204, 95% CI 0.07–0.592, p = 0.03), and switching to MTAs as second-line treatment after LEN (HR 0.299, 95% CI 0.12–0.746, p = 0.01) were significant prognostic factors. Conclusion: Among patients with PD on first-line LEN, good liver function at introduction of LEN was an important and favorable factor related to eligibility for second-line therapy. In addition, post-progression treatment with MTAs could improve the prognosis for patients who had been treated with first-line LEN.

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Role and limitation of neoadjuvant hepatic arterial infusion chemotherapy in advanced hepatocellular carcinoma with Child-Pugh class A

International Journal of Surgery ◽

10.1016/j.ijsu.2020.01.093 ◽

2020 ◽

Vol 75 ◽

pp. S21

Author(s):

Beom-hui Lee ◽

Dong-shik Lee ◽

Chan Woo Cho ◽

Sung-su Yun

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatic Arterial Infusion ◽

Hepatic Arterial Infusion Chemotherapy ◽

Advanced Hepatocellular Carcinoma ◽

Arterial Infusion ◽

Arterial Infusion Chemotherapy ◽

Infusion Chemotherapy ◽

Class A ◽

Pugh Class

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Risk Factors for Liver Function Deterioration after Transarterial Chemoembolization Refractoriness in Child-Pugh Class A Hepatocellular Carcinoma Patients

Korean Journal of Gastroenterology ◽

10.4166/kjg.2020.75.3.147 ◽

2020 ◽

Vol 75 (3) ◽

pp. 147 ◽

Cited By ~ 1

Author(s):

Kang Hyun Park ◽

Jeong Han Kim ◽

Won Hyeok Choe ◽

So Young Kwon ◽

Byung Chul Yoo ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Liver Function ◽

Transarterial Chemoembolization ◽

Class A ◽

Pugh Class

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Sorafenib in patients with Child-Pugh class A and B advanced hepatocellular carcinoma: a prospective feasibility analysis

Annals of Oncology ◽

10.1093/annonc/mds343 ◽

2013 ◽

Vol 24 (2) ◽

pp. 406-411 ◽

Cited By ~ 66

Author(s):

T. Pressiani ◽

C. Boni ◽

L. Rimassa ◽

R. Labianca ◽

S. Fagiuoli ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Feasibility Analysis ◽

Advanced Hepatocellular Carcinoma ◽

Class A ◽

Pugh Class

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The Combination of Albumin–Bilirubin Score and Prothrombin Time Is a Useful Tool for Predicting Liver Dysfunction after Transcatheter Arterial Chemoembolization in Child–Pugh Class A Patients with Hepatocellular Carcinoma within Up-to-Seven Criteria

Journal of Clinical Medicine ◽

10.3390/jcm10214838 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4838

Author(s):

Hiroaki Takaya ◽

Tadashi Namisaki ◽

Soichi Takeda ◽

Kosuke Kaji ◽

Hiroyuki Ogawa ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Function ◽

Prothrombin Time ◽

Liver Dysfunction ◽

Transcatheter Arterial Chemoembolization ◽

Predictive Ability ◽

Recurrence Rates ◽

Class A ◽

Pugh Class ◽

Arterial Chemoembolization

Mortality and recurrence rates of hepatocellular carcinoma (HCC) are high. Recent studies show that for patients with HCC beyond up-to-seven criteria, treatment with molecular-targeted agents (MTAs) is recommended because the treatment efficiency of transcatheter arterial chemoembolization (TACE) is poor; further, TACE increases decline in liver function. However, the relationship between TACE and liver function decline in patients with HCC within up-to-seven criteria has not been clarified. Hence, we aimed to investigate this relationship. This retrospective observational study included 189 HCC tumors within up-to-seven criteria in 114 Child–Pugh class A patients. Twenty-four (12.7%) tumors were changed from Child–Pugh class A to B after TACE, and 116 (61.4%) tumors exhibited recurrence within 6 months after TACE. Prothrombin time (PT) and albumin–bilirubin (ALBI) score before TACE were significantly associated with liver dysfunction from Child–Pugh class A to B. The combination of PT and ALBI score before TACE had high predictive ability for liver dysfunction from Child–Pugh class A to B after TACE (specificity = 100%, sensitivity = 91.7%). The combined use of pre-TACE PT and ALBI score has a high predictive ability for liver dysfunction after TACE for Child–Pugh class A patients with HCC within up-to-seven criteria.

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Complete response to the combination of Lenvatinib and Pembrolizumab in an advanced hepatocellular carcinoma patient: a case report

BMC Cancer ◽

10.1186/s12885-019-6287-8 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Zhaonan Liu ◽

Xingjie Li ◽

Xuequn He ◽

Yingchun Xu ◽

Xi Wang

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Function ◽

Arterial Embolization ◽

Complete Response ◽

Advanced Hepatocellular Carcinoma ◽

Class B ◽

Embolization Treatment ◽

History Of ◽

Pugh Class ◽

Patient’S History

Abstract Background The majority of patients diagnosed with hepatocellular carcinoma (HCC) have advanced diseases and many are not eligible for curative therapies. Case presentation We report a rare case of HCC from a patient who had a complete response (CR) with the use of combination of Lenvatinib and Pembrolizumab. A 63-year-old man presented at the hospital with serious abdominal pain and was found to have a mass with heterogeneous enhancement and with hemorrhage in segment III of the liver after the examination of abdominal computerized tomography (CT) scan. The patient’s history of viral hepatitis B infection, liver cirrhosis and the ɑ-fetoprotein (AFP) level of 14,429.3 ng/ml supported the clinical diagnosis of HCC and laboratory results demonstrated liver function damage status (Child-Pugh class B, Score 8). The patient first received hepatic arterial embolization treatment on 28th November 2017. At this stage supportive care was recommended for poor liver function. In February 2018, combined immunotherapy of Pembrolizumab (2 mg/kg, q3w) and Lenvatinib (8 mg–4 mg, qd) were performed. Nine months following the treatment he had a CR and now, 22 months since the initial treatment, there is no clinical evidence of disease progression. The current overall survival is 22 months. Conclusions HCC is a potentially lethal malignant tumor and the combination of immunotherapy plus anti-angiogenic inhibitors shows promising outcome for advanced diseases.

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