Clinical Edge Journal Scan

CP-A to CP-B progression after lenvatinib initiation in HCC should not halt therapy


Key clinical point: Lenvatinib may continue to benefit patients with unresectable hepatocellular carcinoma (uHCC) despite liver function deterioration to Child-Pugh class B (CP-B) after therapy initiation.

Major finding: CP-B vs CP-A patients receiving lenvatinib had a median progression-free survival (PFS) and overall survival (OS) of 3.7 months (95% CI 1.8-7.4) vs 6.5 months (95% CI 5.6-7.4) and 6.8 months (95% CI 2.6-10.3) vs 13.3 months (95% CI 11.6-16.1), respectively. CP-B patients receiving sorafenib had a median PFS and OS of only 0.5 months (95% CI 0.1-3.6) and 4.5 months (95% CI 2.9-6.1, respectively. Lenvatinib showed no new safety signals in CP-B patients.

Study details: This post hoc analysis included patients with uHCC from the REFLECT trial whose liver function deteriorated to CP-B or remained CP-A within 8 weeks of randomization to lenvatinib (CP-B: n = 60; CP-A: n = 413) or sorafenib (CP-B: n = 47; CP-A: n = 427).

Disclosures: This study was funded by Eisai Inc. and Merck Sharp & Dohme (MSD) LLC. Some authors declared serving as speakers, consultants, or advisors for various organizations, including Eisai and MSD.

Source: Huynh J et al. Lenvatinib in patients with unresectable hepatocellular carcinoma who progressed to Child-Pugh B liver function. Ther Adv Med Oncol. 2022;14:17588359221116608 (Aug 24). Doi: 10.1177/17588359221116608

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