Lenvatinib Treatment in Unresectable Hepatocellular Carcinoma
Summary
Lenvatinib is an oral multi-kinase inhibitor that targets vascular endothelial growth factor receptors, fibroblast growth factor receptors and other pro-oncogenic tyrosine kinases. It has emerged as a first-line systemic therapy for patients with hepatocellular carcinoma that is not amenable to surgical resection or local ablative procedures. Clinical trials have demonstrated that lenvatinib achieves non-inferior overall survival compared with sorafenib, with significant improvements in progression-free survival and objective response rates. Common adverse effects include hypertension, proteinuria, palmar-plantar erythrodysaesthesia and fatigue. Patient selection and management of hepatic function are critical to optimise outcomes, with dose modifications guided by baseline albumin-bilirubin grade, body weight and the emergence of toxicity. Real-world experience has confirmed the importance of careful monitoring and personalised dosing strategies to balance efficacy with tolerability.
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Lenvatinib Treatment in Unresectable Hepatocellular Carcinoma publication trend
The graph below shows the total number of articles in lenvatinib treatment in unresectable hepatocellular carcinoma across all publications each year (not limited to Nature Index journals).
Technical terms
Tyrosine kinase inhibitor (TKI): A small-molecule drug that blocks signalling through receptor tyrosine kinases involved in tumour growth and angiogenesis.
Angiogenesis: The process by which new blood vessels form from pre-existing vasculature, a critical mechanism for tumour sustenance and growth.
Tumour microenvironment (TME): The complex milieu of stromal cells, immune cells, extracellular matrix and signalling molecules surrounding a tumour.
Tumour-associated macrophages (TAMs): Macrophages present within the TME that can adopt pro- or anti-tumour phenotypes and influence response to therapy.
Trans-arterial chemoembolization (TACE): A locoregional procedure that delivers chemotherapy directly into hepatic tumours via the arterial supply, followed by embolic agents to induce ischaemia.
References
- Supramolecular Polymer‐Nanomedicine Hydrogel Loaded with Tumor Associated Macrophage‐Reprogramming polyTLR7/8a Nanoregulator for Enhanced Anti‐Angiogenesis Therapy of Orthotopic Hepatocellular Carcinoma. Advanced Science (2023).
- REFLECT—a phase 3 trial comparing efficacy and safety of lenvatinib to sorafenib for the treatment of unresectable hepatocellular carcinoma: an analysis of Japanese subset. Journal of Gastroenterology (2019).
- Impact of Baseline ALBI Grade on the Outcomes of Hepatocellular Carcinoma Patients Treated with Lenvatinib: A Multicenter Study. Cancers (2019).
- Clinical features of lenvatinib for unresectable hepatocellular carcinoma in real‐world conditions: Multicenter analysis. Cancer Medicine (2018).
- Clinical Significance of Adverse Events for Patients with Unresectable Hepatocellular Carcinoma Treated with Lenvatinib: A Multicenter Retrospective Study. Cancers (2020).
- Weekends-Off Lenvatinib for Unresectable Hepatocellular Carcinoma Improves Therapeutic Response and Tolerability Toward Adverse Events. Cancers (2020).
- Alternating Lenvatinib and Trans-Arterial Therapy Prolongs Overall Survival in Patients with Inter-Mediate Stage HepatoCellular Carcinoma: A Propensity Score Matching Study. Cancers (2021).
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