Effect of Proteinuria Before Lenvatinib Administration on Treatment Response After Atezolizumab Bevacizumab Combination Therapy

IF 1.7 Q3 GASTROENTEROLOGY & HEPATOLOGY JGH Open Pub Date : 2025-01-19 DOI:10.1002/jgh3.70098
Hironori Ochi, Masayuki Kurosaki, Takaaki Tanaka, Nobuharu Tamaki, Kaoru Tsuchiya, Yutaka Yasui, Hiroyuki Marusawa, Toshifumi Tada, Shinichiro Nakamura, Takehiro Akahane, Eisuke Okamoto, Haruhiko Kobashi, Hirotaka Arai, Michiko Nonogi, Namiki Izumi
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Abstract

Aim

We investigated the impact of proteinuria on the therapeutic effect before lenvatinib administration as second-line treatment after atezolizumab-bevacizumab.

Methods

We examined 64 patients who were administered lenvatinib as second-line treatment after discontinuation of atezolizumab and bevacizumab. Proteinuria assessed before lenvatinib administration was considered severe if the qualitative value test (QV) was 3+ or the urine protein/creatinine ratio (UPCR) was ≥ 2.0 (group A, n = 13) and non-severe if the UPCR was < 2.0 or the QV was ≤ 2+ (group B, n = 51).

Results

In the entire cohort, the modified albumin–bilirubin grades were grades 1, 2a, 2b, and 3 in 12, 21, 26, and 5 patients, respectively. Regarding the Barcelona Clinic of Liver Cancer stage, 2, 22, and 40 patients had stages A, B, and C, respectively. The objective response rate (ORR) was 14.0% and the disease control rate (DCR) was 59.3%. The median survival time and progression free survival after administration of lenvatinib was 14.8 (95% confidence interval [CI], 11.3–18.4) and 5.5 (95% CI, 3.6–7.5) months, respectively. The ORR and DCR were 0% and 38.4% for group A (n = 13) and 17.6% and 64.7% for group B (n = 51), respectively. The median time to treatment failure was 2.2 months in group A and 4.2 months in group B (p = 0.120).

Conclusions

Severe proteinuria before lenvatinib as a second-line therapy after atezolizumab-bevacizumab treatment may affect the duration of lenvatinib administration and treatment efficacy.

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Lenvatinib给药前蛋白尿对Atezolizumab -贝伐单抗联合治疗后治疗反应的影响。
目的:探讨蛋白尿对来伐替尼作为阿特唑单抗-贝伐单抗后二线治疗前治疗效果的影响。方法:我们检查了64例在阿特唑单抗和贝伐单抗停药后给予lenvatinib作为二线治疗的患者。如果定性值试验(QV)为3+或尿蛋白/肌酐比值(UPCR)≥2.0,则认为lenvatinib给药前评估的蛋白尿严重(A组,n = 13),如果UPCR为n = 51,则认为蛋白尿不严重。结果:在整个队列中,12例、21例、26例和5例患者的改良白蛋白-胆红素等级分别为1级、2a级、2b级和3级。在巴塞罗那肝癌临床分期中,分别有2名、22名和40名患者处于A期、B期和C期。客观有效率(ORR)为14.0%,疾病控制率(DCR)为59.3%。给予lenvatinib后的中位生存时间和无进展生存期分别为14.8个月(95%可信区间[CI], 11.3-18.4)和5.5个月(95% CI, 3.6-7.5)。A组(n = 13)的ORR和DCR分别为0%和38.4%,B组(n = 51)分别为17.6%和64.7%。治疗失败的中位时间A组为2.2个月,B组为4.2个月(p = 0.120)。结论:在阿特唑单抗-贝伐单抗治疗后,lenvatinib作为二线治疗前出现严重蛋白尿可能会影响lenvatinib给药时间和治疗效果。
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来源期刊
JGH Open
JGH Open GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
3.40
自引率
0.00%
发文量
143
审稿时长
7 weeks
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