OBJECTIVES

Lenvatinib was approved to be the first-line treatment of patients with unresectable hepatocellular carcinoma (HCC) in August 2018. A REFLECT trial showed that lenvatinib was non-inferiority to sorafenib. However, the real-world study between these agents remained unclear. The aim of our study was to analyze the real-world effectiveness of lenvatinib in the patients with HCC.

METHODS

: This was a cohort study by using the electronic medical records database from Chang Gung Medical Foundation in Taiwan. We included the patients with advanced HCC and newly initiating lenvatinib between March 2018 and March 2019. The primary outcome was overall survival (OS) from the use of lenvatinib to the all-cause death, end of observation date or loss of follow-up. The secondary outcome was the duration of treatment. We focused on the features of the included patients, including age, gender, pathogenic factors, Barcelona Clinic Liver Cancer (BCLC) classification, Eastern Cooperative Oncology Group (ECOG) Performance Status, previous treatments and Child-Pugh score.

RESULTS

We included a total of 79 lenvatinib users with mean age 66.9 (SD 10.1) and 75.9% of men in our study. There were 94.8% patients whose ECOG < 2, 86.1% patients belonged to Child-Pugh A. In present study, 48.1% patients had prior systemic therapy and 51.9% had prior loco-regional therapy. The median survival was 12.3 months (95% CI: 9.8-NR months) and median duration of treatment was 2.1 months (IQR: 0.9-4.5 months).

CONCLUSIONS

Comparing with previous studies, the median survival time in this study was similar with the REFLECT trial. However, the duration of treatment was less than REFLECT trial. Future large-scale studies were suggested to confirm the real-world effectiveness between lenvatinib and sorafenib.